Billing code 11313: Shave removalMedicare rate & RVUs in Virginia
Reports shave removal of a single skin lesion larger than 2.0 cm on the face or specified adjacent sites, such as the ear, nose, or lip.
Medicare pays $173.05–$200.98 for 11313 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 11313 covers
This code covers shave removal of one epidermal or dermal lesion larger than 2.0 cm on the face, ears, eyelids, nose, lips, or mucous membrane. A clinician uses a blade or similar instrument to remove the lesion superficially rather than excising it through the full skin thickness. Dermatologists and other clinicians who perform skin procedures commonly use it in office settings; the removed tissue may be submitted for pathologic examination.
Select the code by the lesion’s site and diameter, and document both, along with the shave technique and the lesion treated. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 11313 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $200.98 | $83.73 |
| Virginia | $173.05 | $75.20 |
How the 11313 rate is calculated
Each of 11313’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 11313
RVUs × geographic indexes × conversion factor
Work1.64
1.64 RVUs× 1.000 GPCI
Practice expense3.48
3.48 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
5.2900
Conversion factor
$33.4009
Medicare rate
$176.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 11313
The CMS indicators that decide how 11313 is paid alongside other services.
CMS payment indicators · 11313
Shave removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 9 | The concept doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11313 without 51 · national office
$176.69
Shave removal
11313-51 · Second procedure: 50%
$88.35
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11313 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 11312Shave removal
- Both codes cover shave removal in the same site group. Choose 11313 when the lesion is larger than 2.0 cm; 11312 covers 1.1 to 2.0 cm.
- 11303Shave removal
- The size tier is the same, but 11303 is for covered trunk, arm, or leg sites rather than the face and adjacent sites assigned to 11313.
- 11308Shave removal
- Both codes cover lesions larger than 2.0 cm, but 11308 applies to its scalp, neck, hand, foot, and genital site group.
- 11102Tangential skin biopsy
- Use 11102 for a tangential biopsy of one lesion when the service is performed to obtain a diagnostic specimen; 11313 describes shave removal of a large lesion.
11313 billing questions
When is 11313 selected instead of 11312?
Use 11313 for a qualifying lesion larger than 2.0 cm at the covered facial or adjacent sites. Code 11312 is for a lesion in the same site group measuring 1.1 to 2.0 cm.
Does this code include examination of the removed tissue?
The shave removal is the service reported by 11313. A laboratory or pathologist may report a separate pathology service when the specimen is examined.
How should multiple lesions be reported?
The code describes removal of a single lesion. Document each lesion’s site and diameter, and apply the standard multiple-procedure reduction when multiple procedures are performed in the same session.
What documentation supports 11313?
Record the specific facial or adjacent site, lesion diameter greater than 2.0 cm, and that the lesion was removed by a superficial shave technique.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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