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See a sample rate comparisonCPT 11312 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Shave Skin Lesion 1 1 2 0 Cm, Shaving Of Epidermal Or Dermal Lesion Single Lesion Face Ears Eyelids Nose Lips Mucous Membrane Lesion Diameter 1 1 To 2 0 Cm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 11312 |
| Medicaid Fee Schedule | View Medicaid rates for 11312 |
National average reimbursement for CPT 11312 by major payers:
$161.70
$185.82
$189.09
$131.00
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CPT 11312
5 of 25 sample ratesHigher to lower in this preview
Retinal Ambulatory Surgery Center Of New York, Inc.
Retinal Ambulatory Surgery Center Of Ny, Inc.
$680.00Published rateHutchinson Clinic, P.A., Inc., Hutchinson Clinic Endoscopy Center
Hutchinson Clinic, P.A.
$508.00Published rateScottsdale Eye Institute, Plc, Scottsdale Eye Institute, Plc
Scottsdale Eye Institute Plc
$248.00Published rateHealth & Wellness Surgery Center, Tower Surgery Center
Health Wellness Surgery Center
$142.00Published ratePlastic Surgery Specialists, PC
Plastic Surgery Specialists, P.C.
$44.00Published rate
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See a sample payer proposalCPT 11312 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 11312 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 11312 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 11310-CPT | Low | Shave Skin Lesion 0 5 Cm, Shaving Of Epidermal Or Dermal Lesion Single Lesion Face Ears Eyelids Nose Lips Mucous Membrane Lesion Diameter 0 5 Cm Or Less |
| 11311-CPT | Low | Shave Skin Lesion 0 6 1 0 Cm, Shaving Of Epidermal Or Dermal Lesion Single Lesion Face Ears Eyelids Nose Lips Mucous Membrane Lesion Diameter 0 6 To 1 0 Cm |
| 11312-CPT | Low | Shave Skin Lesion 1 1 2 0 Cm, Shaving Of Epidermal Or Dermal Lesion Single Lesion Face Ears Eyelids Nose Lips Mucous Membrane Lesion Diameter 1 1 To 2 0 Cm |
| 11313-CPT | Low | Shave Skin Lesion 2 0 Cm, Shaving Of Epidermal Or Dermal Lesion Single Lesion Face Ears Eyelids Nose Lips Mucous Membrane Lesion Diameter Over 2 0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 11312 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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