Summary & Overview
CPT 11313: Shaving of Epidermal/Dermal Lesion ≥2.0 cm on Face or Mucous Membranes
CPT code 11313 represents shaving removal of a single epidermal or dermal lesion measuring 2.0 cm or greater from high-risk anatomic sites such as the face, ears, eyelids, nose, lips, or mucous membranes. This code captures a common minor surgical dermatologic procedure that has implications for specialty practice billing, coding compliance, and downstream pathology or repair services. Nationally, accurate use of this code supports appropriate reimbursement, clinical documentation, and data capture for procedural dermatology.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides payor-aligned benchmarks and coding guidance, clarifies clinical context for when shaving techniques apply to larger lesions in cosmetically and functionally sensitive areas, and outlines common billing considerations. Readers will find an overview of service definitions, typical sites of service, expected documentation elements, and comparisons to related procedural options. Where payer-specific policy details are required, the report highlights how commercial plans and Medicare commonly approach coverage and coding for minor dermatologic surgical procedures.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 11313 describes shaving removal of a single epidermal or dermal lesion that is 2.0 cm or greater in diameter from the face, ears, eyelids, nose, lips, or mucous membranes. This procedure is an operative dermatologic service focused on lesion removal by shaving technique.
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Service type: Minor surgical/dermatologic procedure (shaving of lesion)
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Typical site of service: Ambulatory surgical centers, hospital outpatient departments, dermatology clinics, and office-based procedure rooms for procedures involving the face, ears, eyelids, nose, lips, or mucous membranes.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient dermatology clinic with a solitary raised pigmented or nonpigmented lesion on the face (cheek, nose, forehead), ear, eyelid margin, lip, or oral mucosa. After history and focused skin examination, the clinician documents lesion size ≥2.0 cm in greatest diameter and discusses treatment options. The provider performs a shave removal of the epidermal/dermal lesion in a procedure room under local anesthesia (e.g., 1% lidocaine with or without epinephrine). Hemostasis is achieved with electrocautery or chemical cautery; specimen is submitted for pathology when indicated. Post-procedure instructions and wound care are reviewed; the clinician documents informed consent, lesion measurements, anatomic site, and whether pathology was sent. Typical sites of service include outpatient dermatology offices, ambulatory surgical centers, and physician offices. Common payors involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Overall professional services | When a separate significant, separately identifiable evaluation and management service is performed on the same day as the procedure and fully documented |
22 |