MBS item 31363: Skin cancer excision, face/neck/scalp/distal limb, 14 mm+

What to check before you bill item 31363

Each line links to the MBS passage it comes from.

• A BCC or SCC (including keratoacanthoma), a cutaneous lymphoma deposit, or a skin metastasis (the malignant skin lesions TN.8.125 defines); not a melanoma-type cancer Item 31363
• A skin lesion, not a mucous membrane one Item 31363
• Malignancy confirmed by histology of this specimen or a previous biopsy Item 31363
• Surgical (full-thickness) excision, not a shave Item 31363
• On the face (in front of the hairline, above the jawline), neck, scalp or nipple-areola, or the leg from the knee down or the arm from the wrist down, other than the nose, eyelid, eyebrow, lip, ear, digit, or genital sites Item 31363
• Necessary excision diameter (lesion plus margin, measured before excising) 14 mm or more Item 31363
• Specimen sent for histology Item 31363
• Excised with the intent of removing the whole lesion (with a clinically appropriate margin), not sampling it TN.8.125
• The lesion and margin were measured before excising TN.8.125
• Histology report and supporting evidence kept; photos include a scale TN.8.125
• Don't issue the account until histology confirming malignancy has been received TN.8.22
• An incomplete excision of a skin cancer done with curative intent still counts as a malignant excision, even if more surgery is needed TN.8.22
• Excising a common wart or seborrhoeic keratosis is billed as a consult (attendance), not as an excision TN.8.22

Billing item 31363 with other items

With a consultation on the same day: only if it’s distinct. A consult on the same day only if clinically relevant and distinct from the excision AN.0.9

Can’t be billed with item 31363

• Bladder catheterisation (item 36800)
  • Only when no other procedure is done on the same occasion: not with another operation (Group T8), such as a wound repair or a suprapubic stab cystotomy Item 36800
• Ganglion excision (item 30107)
  • Not with another surgical operation (Group T8) on the same occasion Item 30107
• IUD insertion (items 35503 and 82201)
  • Not with another Group T8 (surgical) item on the same occasion, apart from the items it names as exceptions: only one is paid, and the MBS doesn't settle which (the item's wording bars the IUD insertion; note TN.8.1 reads the same words as barring the other item), so bill one Item 35503
• Rigid sigmoidoscopy (items 32072 and 32075)
  • Not with another operation (Group T8) on the same occasion Item 32075
• Skin flap repair (items 45200, 45203, 45206, and 45207)
  • Not with an excision of a skin cancer, suspected melanoma, or non-malignant skin lesion Item 45207
• Skin lesion destruction (freezing, curette, cautery, laser) (item 30189)
  • Not with another Group T8 (surgical) item on the same occasion Item 30189

Only in some cases with item 31363

• Acupuncture (items 193, 195, 197, and 199)
  • A consult on the same day only if clinically relevant and distinct from the excision AN.0.9
• General consultation (all 153 items, including 23, 36, 91891, 3, 4, and 24)
  • A consult on the same day only if clinically relevant and distinct from the excision AN.0.9
• Prolonged attendance on a patient in imminent danger of death (all 10 items, including 160, 161, 162, 163, 164, and 214)
  • A consult on the same day only if clinically relevant and distinct from the excision AN.0.9
• Patient-end support for a specialist video consultation (all 32 items, including 373, 374, 375, 376, 377, and 378)
  • A consult on the same day only if clinically relevant and distinct from the excision AN.0.9
• Urgent after-hours attendance (all 8 items, including 585, 588, 591, 594, 599, and 600)
  • A consult on the same day only if clinically relevant and distinct from the excision AN.0.9
• Excision of four or more small lesions (items 31220, 31221, and 31225)
  • Four or more small skin cancers (each 10 mm or less) cut out at one visit fit the item for several lesions once, and each also fits the skin cancer excision item for its site and size. Neither item excludes the other, and the guidance on items for several lesions doesn’t say whether it takes in proven skin cancers: the doctor chooses Services Australia guidance
• Skin or mucous membrane biopsy (items 30071, 35615, and 30072)
  • A punch or elliptical biopsy that removes a small lesion whole, taken to confirm a diagnosis, also fits a surgical excision of that lesion. Only the purpose separates them (a sample to confirm a diagnosis, or removal with a margin), and 'punch excision' doesn't say which. The MBS names no winner: pick one TN.8.7
• Lump excision (lipoma, cyst, or soft tissue tumour) (item 31227)
  • An epidermoid (sebaceous) or other cyst fits both the non-malignant skin lesion items ('including a cyst') and the subcutaneous cyst excision (31227); no fact separates skin from subcutaneous here and the MBS names no winner: pick one Item 31366
• Wound repair (laceration repair) (all 8 items, including 30026, 30029, 30032, 30035, 30038, and 30042)
  • Closing the excision defect is part of the excision, even if it is closed at a later visit: it is not a separate wound repair TN.8.125

Bulk-billing incentive

An extra payment when a doctor bulk bills an unreferred service. With item 31363, one of these:

Other versions

Skin lesion excision has 32 items. The closest to item 31363:

What comes next

• If histology confirms a melanoma or another rare skin cancer, a wide excision of the tumour bed may follow as its own excision. (items 31373, 31356, 31358, and 31361)
• A consultation that uses the histology result to decide further management can be billed. Only giving the result is part of the excision. (items 23, 36, 91891, and 3)

Often done at the same visit

• A skin check often finds more than one lesion of concern: one is excised, another is sampled by punch or shave biopsy to make a diagnosis first. (items 30071, 35615, and 30072)
• Patients having a skin cancer excised often have sun damage, and their solar keratoses are frozen at the same visit; 10 or more treated has its own item. (items 30196, 30202, and 30187)

Common questions

What is the fee for MBS item 31363?

The schedule fee is $292.35, and the Medicare benefit is 85% of it ($248.50). That’s under the MBS in force from 1 August 2026.

Can item 31363 be claimed on the same day as a consultation?

Yes, if it’s distinct. A consult on the same day only if clinically relevant and distinct from the excision.

Can you bill 31363 and 23 together?

Only in some cases. A consult on the same day only if clinically relevant and distinct from the excision. (Source: MBS AN.0.9.)

Can you bill 31363 and 36800 together?

No. Only when no other procedure is done on the same occasion: not with another operation (Group T8), such as a wound repair or a suprapubic stab cystotomy. (Source: MBS Item 36800.)

Can you bill 31363 and 30107 together?

No. Not with another surgical operation (Group T8) on the same occasion. (Source: MBS Item 30107.)

What can’t item 31363 be billed with?

The MBS has a rule against billing item 31363 with these: bladder catheterisation, ganglion excision, IUD insertion, rigid sigmoidoscopy, skin flap repair, and skin lesion destruction (freezing, curette, cautery, laser). Each rule and its source is on this page.

Can item 31363 be billed with a bulk-billing incentive?

Yes. An extra payment when a doctor bulk bills an unreferred service. The items are 10990, 10991, 75855, 75856, 75857, and 75858.

Sources

• Item 31363: Group T8 Surgical Operations › Subgroup 1 General
• Note TN.8.125: Removal of Skin Lesions - Necessary Excision Diameter - (Items 31356 to 31388)
• Note TN.8.22: Removal of Skin Lesions - (Items 31356 to 31388)
• Note AN.0.9: Using time-tiered professional (general) attendance items
• Item 36800: Group T8 Surgical Operations › Subgroup 5 Urological
• Item 30107: Group T8 Surgical Operations › Subgroup 1 General
• Item 35503: Group T8 Surgical Operations › Subgroup 4 Gynaecological
• Services Australia guidance: MBS billing for skin lesion treatment and biopsy items: Billing multiple services
• Item 32075: Group T8 Surgical Operations › Subgroup 2 Colorectal
• Item 45207: Group T8 Surgical Operations › Subgroup 13 Plastic And Reconstructive Surgery
• Item 45200: Group T8 Surgical Operations › Subgroup 13 Plastic And Reconstructive Surgery
• Item 45203: Group T8 Surgical Operations › Subgroup 13 Plastic And Reconstructive Surgery
• Item 45206: Group T8 Surgical Operations › Subgroup 13 Plastic And Reconstructive Surgery
• Item 30189: Group T8 Surgical Operations › Subgroup 1 General
• Note TN.8.7: Biopsy for Diagnostic Purposes - (Items 30071 to 30094 and 30820)
• Item 31366: Group T8 Surgical Operations › Subgroup 1 General
• Note TN.8.297: Healing by secondary intention
• Item 31358: Group T8 Surgical Operations › Subgroup 1 General
• Note TN.8.23: Removal of Skin Lesion From Face - (Items 31245, 31361 to 31364, 31372, 31373, 31379 and 31380)
• Item 31365: Group T8 Surgical Operations › Subgroup 1 General
• Item 31371: Group T8 Surgical Operations › Subgroup 1 General
• Item 31386: Group T8 Surgical Operations › Subgroup 1 General