CPT 11312
Global 000 ActiveShave skin lesion 1.1-2.0 cm
CPT 11312 Billing & Documentation Guide
CPT code 11312 (Shave skin lesion 1.1-2.0 cm) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.27, a non-facility practice expense RVU of 3.11, and a malpractice RVU of 0.13, a total non-facility RVU of 4.51 and facility RVU of 1.81. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $155.41, though rates vary from $133.89 to $199.2 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11312, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 11312 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 3 units of 11312 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 11312
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.27 | 1.27 |
| Practice Expense RVU | 3.11 | 0.41 |
| Malpractice RVU | 0.13 | 0.13 |
| Total RVU | 4.51 | 1.81 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11312
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $169.21 | $62.5 | $159.32 - $199.2 | 29 |
| Florida | $155.1 | $64.61 | $148.25 - $161.54 | 3 |
| Georgia | $146.78 | $60.74 | $140.25 - $153.3 | 2 |
| Illinois | $151.24 | $64.1 | $144.05 - $157.09 | 4 |
| Michigan | $146.07 | $61.39 | $142.16 - $149.98 | 2 |
| North Carolina | $142.11 | $57.97 | $142.11 - $142.11 | 1 |
| New York | $166.22 | $65.61 | $144.15 - $176.71 | 5 |
| Ohio | $141.64 | $59.3 | $141.64 - $141.64 | 1 |
| Pennsylvania | $149.19 | $60.86 | $141.88 - $156.5 | 2 |
| Texas | $148.95 | $60.17 | $140.98 - $156.25 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 11312
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11312 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0419T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0420T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11312
What does CPT code 11312 mean? +
CPT code 11312 represents: Shave skin lesion 1.1-2.0 cm. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11312? +
The 2026 Medicare national average non-facility payment for CPT 11312 is $155.41. Rates range from $133.89 to $199.2 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11312? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 11312? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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