How much does Medicare pay for CPT 11312?

Medicare allowed an average of $129.94 per service and paid $97.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $270.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 11312?

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm. It was billed 25,657 times to 18,869 Medicare beneficiaries by 527 providers in 2024.

Does 11312 pay differently in an office than a hospital?

Yes. The allowed amount averaged $131.25 in an office setting and $55.13 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 11312 most?

Dermatology, with 20,149 services from 378 clinicians. Next are Physician Assistant, Nurse Practitioner, Micrographic Dermatologic Surgery.

CPT 11312

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm

$129.94Medicare-allowed amount per service, averaged across 25,657 services

Providers submitted

$270.68

Asking price, not received

Medicare allowed

$129.94

The fee schedule figure

Medicare paid

$97.25

Balance is patient coinsurance

Providers submitted an average of $270.68 for this code and Medicare allowed $129.94 — 2.1× 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 $97.25 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $131.25
Hospital / facility: $55.13

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. 25,215 services were billed in an office setting and 442 in a facility.

Services: 25,657
Beneficiaries: 18,869
Providers billing it: 527
Total allowed: $3,333,871

What Medicare pays for CPT 11312

Across 25,657 services billed by 527 providers to 18,869 beneficiaries, Medicare allowed an average of $129.94 per service. That is 1.4 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 11312

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	20,149	14,571	$133.05	378
Physician Assistant	2,545	1,971	$114.94	74
Nurse Practitioner	1,178	932	$111.83	33
Micrographic Dermatologic Surgery	759	629	$140.40	8
Plastic and Reconstructive Surgery	532	399	$117.76	16
Otolaryngology	209	145	$102.16	6
Family Practice	162	136	$147.34	6
Internal Medicine	92	61	$124.14	4
Ambulatory Surgical Center	17	14	$46.45	1
General Surgery	14	11	$154.32	1

11312 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	4,542	$145.36	$97.71	65
Pennsylvania	1,945	$136.85	$93.54	33
New Jersey	1,909	$133.50	$91.32	35
New York	1,792	$145.46	$95.61	31
South Carolina	1,779	$124.14	$99.40	12
Florida	1,398	$131.78	$97.39	44
Kentucky	1,148	$90.38	$74.45	7
North Carolina	985	$122.35	$94.88	16
Arizona	970	$113.68	$76.91	9
Texas	790	$131.55	$99.16	29
Ohio	786	$120.46	$91.48	30
Virginia	732	$134.83	$91.34	15
Illinois	675	$144.12	$100.75	23
Georgia	642	$128.58	$101.82	9
Nebraska	511	$97.55	$73.55	6
Indiana	499	$118.79	$91.05	18
Colorado	442	$116.11	$83.66	4
Mississippi	392	$107.15	$90.88	3
Missouri	377	$120.28	$94.70	14
Nevada	375	$141.10	$106.65	8
Washington	369	$133.89	$91.91	9
Alabama	279	$109.32	$93.55	7
Minnesota	257	$120.31	$84.54	9
Maryland	214	$151.07	$97.40	6
Michigan	171	$135.64	$100.95	9
Oregon	164	$137.29	$97.67	6
Wisconsin	159	$99.16	$74.02	7
Arkansas	126	$108.64	$87.20	4
South Dakota	110	$44.93	$35.97	3
Montana	96	$142.84	$95.10	3
Massachusetts	96	$155.60	$98.22	5
New Mexico	96	$146.23	$106.55	2
Delaware	90	$149.86	$109.80	4
Tennessee	90	$119.90	$89.26	5
Kansas	80	$118.15	$83.23	4
West Virginia	70	$113.59	$86.39	4
New Hampshire	67	$152.35	$103.48	4
Idaho	64	$134.70	$108.91	3
Wyoming	50	$137.76	$107.24	4
North Dakota	45	$133.74	$99.14	2
Louisiana	42	$127.02	$97.03	2
Utah	42	$118.27	$87.90	3
Vermont	34	$63.53	$38.16	1
Connecticut	32	$141.02	$88.27	2
Oklahoma	31	$140.81	$102.27	2
Hawaii	19	$139.48	$97.22	1
Iowa	18	$127.21	$93.17	1
District of Columbia	16	$157.71	$98.50	1
Rhode Island	15	$163.86	$107.68	1
Alaska	15	$174.93	$113.75	1
Maine	11	$115.58	$85.96	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
11311Shaving of skin growth of face$109.39
11305Shaving of skin growth of scalp$83.95
11307Shaving of skin growth of scalp$109.50
11310Shaving of skin growth of face$87.93
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.