Summary & Overview
CPT 11312: Shave Removal of Lesion on Face or Mucous Membrane, 1.1–2.0 cm
CPT code 11312 identifies shave removal of a single epidermal or dermal lesion measuring 1.1–2.0 cm located on the face, ears, eyelids, nose, lips, or mucous membranes. This procedural code is widely used in dermatology and otolaryngology and is relevant for national billing, coding compliance, and payer coverage determinations because of the frequency of cutaneous lesion treatments in outpatient settings. Key payers typically involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what the code represents in clinical and billing terms, the typical setting and clinical indications for its use, and the scope of payers covered in this overview. The publication provides concise benchmarks and contextual information on common billing practices, payer coverage considerations, and how the code is documented in service lines for dermatologic procedures. Where input data is incomplete, the report notes "Data not available in the input." The content is intended for billing professionals, clinicians, and policy analysts seeking a national-level briefing on CPT code 11312.
Billing Code Overview
CPT code 11312 describes the surgical shaving of a single epidermal or dermal lesion measuring 1.1 to 2.0 cm in diameter. The procedure involves shaving the lesion down to the level of the surrounding skin and is targeted at anatomically sensitive areas: the face, ears, eyelids, nose, lips, or mucous membranes.
Service Type: Lesion removal — shave excision
Typical Site of Service: Ambulatory surgical center or office-based dermatologic procedure room, performed on the specified facial or mucosal locations.
Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to a dermatology clinic with a solitary raised pigmented papule on the lateral nose measuring 1.5 cm in greatest diameter. The lesion has changed in color over several months and the clinician elects an in-office shave excision for diagnostic and therapeutic purposes. After obtaining informed consent, the patient is positioned in a procedure chair in an outpatient clinic treatment room. The site is cleansed, local anesthesia (e.g., 1% lidocaine with epinephrine) is infiltrated, and the provider performs a tangential shave removal of the lesion down to the level of the dermis using a scalpel or razor blade. Hemostasis is achieved with electrocautery or chemical cautery, and a topical antibiotic ointment and dressing are applied. The specimen is placed in formalin and sent to pathology for histologic evaluation. The procedure is documented with lesion size (1.5 cm), anatomic site (nose), technique (shave excision), anesthesia, estimated blood loss, hemostasis method, and disposition of the specimen. Typical billing uses 11312 for a single epidermal or dermal lesion of 1.1 to 2.0 cm on the face, nose, eyelids, lips, ears, or mucous membranes. Typical site of service is an ambulatory clinic/physician office or outpatient dermatology procedure room. Payors involved in authorization or adjudication may include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA (Blue United Care Alliance), and Medicare, following each payor's policy on lesion removal and pathology processing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. | Data not available in the input. |
26 | Professional component | Use when reporting only the professional component of a service (e.g., pathology professional interpretation billed separately). |
50 | Data not available in the input. | Data not available in the input. |
51 | Multiple procedures | Append when multiple distinct procedures are performed during the same encounter and payer requires modifier for additional procedures. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described by the full code. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances or patient condition. |
59 | Distinct procedural service | Use to indicate a distinct and separate procedure or service, different session, site, or lesion, when supported by documentation. |
76 | Repeat procedure by same physician | Use if the exact procedure is repeated by the same provider on the same day. |
77 | Data not available in the input. | Data not available in the input. |
79 | Unrelated procedure by same physician during postoperative period | Use when an unrelated procedure is performed during the global period and is not related to the initial procedure. |
TC | Technical component | Use when billing only the technical component (e.g., pathology laboratory technical charges) separately from professional interpretation. |
LT | Left side | Use to identify laterality when applicable (e.g., left ear, left eyelid). |
RT | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Primary specialty performing shave excisions on the face and mucous membranes. |
208000000X | General Practice | Primary care providers may perform simple shave removals in office settings. |
1835P0206X | Otolaryngology (ENT) | ENT surgeons perform shave removals on lesions of the ear, nose, and mucous membranes when indicated. |
207L00000X | Plastic Surgery | Plastic surgeons perform lesion removal on cosmetically sensitive facial areas and complex reconstructions. |
103T00000X | Dermatopathology | Providers involved in pathology interpretation of the excised specimen. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L71.0 | Perioral acne | Shave removal may be used for diagnostic or therapeutic removal of epidermal/dermal lesions presenting in acneiform conditions. |
L98.0 | Hyperkeratosis | Shave excision can remove hyperkeratotic epidermal lesions for symptom relief and diagnosis. |
D23.9 | Other benign neoplasm of skin, unspecified | Common indication for shave removal when lesion appears benign and superficial. |
C44.311 | Squamous cell carcinoma of right eyelid, including canthus | Lesions suspicious for cutaneous malignancy on face/mucous membranes may be removed for diagnosis; further management depends on pathology. |
C44.31 | Basal cell carcinoma of skin of eyelid, including canthus | Superficial suspicious lesions may be sampled via shave excision though definitive management often requires excision with margins. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11312 | The provider shaves off a single epidermal or dermal lesion of 1.1 to 2.0 cm in diameter from the face, ears, eyelids, nose, lips, or mucous membranes. | Primary procedure code described. |
11102 | Tangential biopsy of skin (shave), single lesion; up to 0.5 cm | Performed for smaller lesions; used when lesion size is ≤ 0.5 cm instead of 11312. |
11103 | Tangential biopsy of skin (shave), single lesion; 0.6 to 1.0 cm | Performed when lesion size falls within 0.6–1.0 cm range; alternative to 11312 for smaller lesions. |
11402 | Excision, benign lesion including margins, face, ears, eyelids, nose, lips; lesion diameter 0.6 to 1.0 cm; excised diameter 1.1 to 2.0 cm | Used when full-thickness elliptical excision is indicated instead of a shave, commonly for deeper or suspicious lesions requiring primary closure. |
88305 | Level IV surgical pathology, gross and microscopic examination | Billing for pathology interpretation of the excised specimen when submitted to the laboratory. |
99024 | Postoperative follow-up visit, included | Represents routine postoperative global period visits; documented as part of global package when applicable. |