CPT 11313
Global 000 ActiveShave skin lesion >2.0 cm
CPT 11313 Billing & Documentation Guide
CPT code 11313 (Shave skin lesion >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 1.64, a non-facility practice expense RVU of 3.48, and a malpractice RVU of 0.17, a total non-facility RVU of 5.29 and facility RVU of 2.31. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $182.07, though rates vary from $157.55 to $231.46 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 11313, 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 11313 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 11313 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 11313
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.64 | 1.64 |
| Practice Expense RVU | 3.48 | 0.5 |
| Malpractice RVU | 0.17 | 0.17 |
| Total RVU | 5.29 | 2.31 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 11313
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 | $197.36 | $79.58 | $186.15 - $231.46 | 29 |
| Florida | $182.45 | $82.59 | $174.43 - $190.14 | 3 |
| Georgia | $172.55 | $77.59 | $165.23 - $179.86 | 2 |
| Illinois | $178.14 | $81.96 | $169.78 - $185.01 | 4 |
| Michigan | $171.92 | $78.46 | $167.31 - $176.52 | 2 |
| North Carolina | $166.85 | $73.99 | $166.85 - $166.85 | 1 |
| New York | $194.76 | $83.72 | $169.19 - $207.03 | 5 |
| Ohio | $166.62 | $75.75 | $166.62 - $166.62 | 1 |
| Pennsylvania | $175.2 | $77.7 | $166.85 - $183.54 | 2 |
| Texas | $174.79 | $76.79 | $165.83 - $182.89 | 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 11313
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 11313 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 |
| 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 |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 11313
What does CPT code 11313 mean? +
CPT code 11313 represents: Shave skin lesion >2.0 cm. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 11313? +
The 2026 Medicare national average non-facility payment for CPT 11313 is $182.07. Rates range from $157.55 to $231.46 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 11313? +
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 11313? +
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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