How much does Medicare pay for CPT 11311?

Medicare allowed an average of $109.39 per service and paid $80.93 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $256.74, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11311?

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm. It was billed 64,760 times to 53,285 Medicare beneficiaries by 1,307 providers in 2024.

Does 11311 pay differently in an office than a hospital?

Yes. The allowed amount averaged $110.58 in an office setting and $42.00 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 11311 most?

Dermatology, with 41,414 services from 809 clinicians. Next are Physician Assistant, Nurse Practitioner, Plastic and Reconstructive Surgery.

CPT 11311

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm

$109.39Medicare-allowed amount per service, averaged across 64,760 services

Providers submitted

$256.74

Asking price, not received

Medicare allowed

$109.39

The fee schedule figure

Medicare paid

$80.93

Balance is patient coinsurance

Providers submitted an average of $256.74 for this code and Medicare allowed $109.39 — 2.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $80.93 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $110.58
Hospital / facility: $42.00

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 63,639 services were billed in an office setting and 1,121 in a facility.

Services: 64,760
Beneficiaries: 53,285
Providers billing it: 1,307
Total allowed: $7,084,096

What Medicare pays for CPT 11311

Across 64,760 services billed by 1,307 providers to 53,285 beneficiaries, Medicare allowed an average of $109.39 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 11311

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	41,414	34,187	$114.53	809
Physician Assistant	13,060	10,842	$97.69	292
Nurse Practitioner	5,922	4,883	$98.14	121
Plastic and Reconstructive Surgery	1,377	972	$102.98	30
Micrographic Dermatologic Surgery	1,053	872	$114.71	11
Otolaryngology	575	417	$103.18	13
Internal Medicine	521	395	$121.52	7
Family Practice	416	367	$114.71	12
General Surgery	133	99	$116.70	2
Undefined Physician type	105	87	$121.47	2
Pathology	86	77	$117.96	3
Pediatric Medicine	31	28	$131.73	2
General Practice	25	22	$139.30	1
Ophthalmology	23	21	$120.63	1
Obstetrics & Gynecology	19	16	$123.48	1

11311 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	8,552	$123.12	$79.23	169
New York	4,466	$119.15	$78.56	78
Pennsylvania	4,322	$110.13	$78.77	82
Florida	4,166	$115.54	$85.20	90
Ohio	3,810	$103.96	$78.30	80
Illinois	3,279	$116.04	$79.53	75
South Carolina	3,274	$93.85	$72.93	32
New Jersey	2,812	$116.22	$76.70	60
Texas	2,744	$109.75	$82.54	66
North Carolina	2,689	$99.85	$75.06	42
Nebraska	2,294	$74.20	$56.66	13
Arizona	1,528	$105.94	$79.77	32
Minnesota	1,511	$106.44	$75.16	29
Georgia	1,475	$104.16	$79.93	21
Virginia	1,469	$119.65	$83.61	37
Indiana	1,460	$105.77	$80.26	42
Washington	1,069	$113.07	$76.96	20
Kentucky	987	$86.32	$71.93	13
Missouri	976	$100.60	$77.32	16
Nevada	835	$110.34	$82.29	11
West Virginia	785	$96.87	$74.06	19
Massachusetts	763	$125.47	$82.26	18
Alabama	723	$97.70	$80.69	20
Oregon	679	$113.30	$78.82	11
Wyoming	652	$110.10	$83.93	9
Maryland	592	$124.78	$80.23	19
New Hampshire	561	$117.39	$78.31	11
Michigan	559	$122.07	$87.92	23
Wisconsin	535	$90.20	$67.90	15
South Dakota	455	$55.99	$42.30	13
Louisiana	445	$110.50	$86.67	7
Tennessee	438	$95.95	$76.11	13
Arkansas	414	$94.97	$75.61	16
Iowa	402	$102.88	$75.43	15
Colorado	387	$109.21	$76.11	11
Delaware	353	$116.81	$86.40	7
New Mexico	304	$112.48	$84.52	5
Montana	270	$116.10	$79.72	4
North Dakota	238	$98.19	$73.17	8
Idaho	235	$108.72	$81.39	9
Utah	228	$108.64	$83.09	10
Oklahoma	217	$119.19	$81.54	6
Mississippi	179	$97.64	$81.82	3
District of Columbia	154	$133.83	$86.08	4
Kansas	111	$117.18	$83.38	6
Connecticut	103	$133.51	$88.18	6
Hawaii	100	$120.21	$81.10	4
Rhode Island	69	$131.35	$85.98	2
Maine	38	$105.23	$69.15	2
Alaska	21	$126.97	$79.74	1
Vermont	19	$47.98	$28.41	1
Puerto Rico	13	$114.07	$90.49	1

Related codes

11301Shaving of skin growth of body$93.24
11306Shaving of skin growth of scalp$96.85
11302Shaving of skin growth of body$109.25
11300Shaving of skin growth of body$65.68
11305Shaving of skin growth of scalp$83.95
11307Shaving of skin growth of scalp$109.50
11310Shaving of skin growth of face$87.93
11312Shaving of skin growth of face$129.94
11308Shaving of skin growth of scalp$117.09
11303Shaving of skin growth of body$124.56
11313Shaving of skin growth of face$169.53

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.