Summary & Overview
CPT 11400: Excision of Benign Skin Lesion, Trunk/Arms/Legs ≤0.5 cm
CPT code 11400 covers the excision of a benign (noncancerous) skin lesion 0.5 cm or smaller, including margins, from the trunk, arms, or legs. As a common minor surgical procedure in dermatology and primary care, this code is widely used across outpatient clinics, physician offices, and ambulatory surgery centers. Accurate coding for small lesion excisions matters nationally for clinical documentation, billing compliance, and appropriate reimbursement for procedural services.
This analysis references major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and service contexts, typical payers that reimburse for this service, and what to expect in benchmark and policy discussions. The publication summarizes how 11400 is positioned among related minor excision codes, highlights documentation elements that support code selection, and outlines common areas of payer review and prior authorization trends.
The content is intended for clinicians, billing professionals, and policy analysts seeking a national-level briefing on coding, billing considerations, and the clinical scope of CPT code 11400. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 11400 describes the excision of a noncancerous skin lesion (excluding skin tags) 0.5 cm or less in diameter, including margins, from the trunk, arms, or legs. This procedure is a minor surgical skin excision performed to remove benign lesions such as small cysts, nevi, or other nonmalignant growths.
Service type: Minor surgical skin excision
Typical site of service: Outpatient clinic, physician office, or ambulatory surgery center on the trunk, arms, or legs
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an outpatient dermatology clinic with a solitary, benign-appearing papule on the posterior forearm that has been present for months and occasionally bleeds with minor trauma. The dermatologist performs a focused history and exam, documents lesion size (0.4 cm diameter including margins), obtains informed consent, prepares the skin with antiseptic, applies local anesthesia, and performs an elliptical excision of the lesion. Hemostasis is achieved, the wound is closed with a few interrupted sutures, and the specimen is labeled for pathology if submitted. Typical workflow includes pre-visit triage, procedure documentation capturing lesion location, size, technique and closure, CPT code selection for excision of a benign lesion on an extremity of 0.5 cm or less (11400), appropriate ICD-10 diagnostic code for the lesion, and application of any applicable modifier(s) before billing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the same day | When a distinct evaluation and management visit is provided on same day as 11400 (e.g., separate decision-making for lesion management) |
26 | Professional component | When reporting only the professional component of a service (rare for simple excisions) |
50 | Bilateral procedure | When identical benign lesions are excised from symmetric sites on both sides during same session |
51 | Multiple procedures | When 11400 is performed in same operative session with other distinct procedures and payer requires multiple-procedure reporting |
52 | Reduced services | When the procedure is partially reduced or not completed as described (e.g., incomplete excision due to bleeding) |
53 | Discontinued procedure | When the procedure is terminated due to extenuating circumstances (e.g., patient instability) |
59 | Distinct procedural service | When another procedure performed on the same day is distinct and separate from 11400 (use with caution and documentation) |
76 | Repeat procedure by same physician | When the same lesion excision is repeated by the same physician later the same day |
77 | Repeat procedure by another physician | When another physician repeats the same procedure on the same day |
79 | Unrelated procedure or service by the same physician during the postoperative period | When an unrelated procedure is performed during the global period for a prior surgery |
RT | Right side | To designate the right side when laterality is relevant (paired with LT) |
LT | Left side | To designate the left side when laterality is relevant (paired with RT) |
22 | Increased procedural services | When work required is substantially greater than typical for 11400 and documentation supports unusual effort |
52 | Reduced services | When the service is partially reduced or not performed to full definition (duplicate of above) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207N00000X | Dermatology | Most common specialty performing skin lesion excisions on trunk/arms/legs |
| 207P00000X | Plastic Surgery | Performs excisions requiring complex closures or cosmetic considerations |
| 208000000X | Family Medicine | Commonly performs minor skin procedures in office settings |
| 207L00000X | Dermatopathology | Involved when specimens are submitted for microscopic diagnosis |
| 207K00000X | General Surgery | May perform excisions for lesions referred from clinic |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L91.8 | Other hypertrophic disorders of the skin | Benign raised lesions that may be excised if symptomatic or for cosmesis |
L98.9 | Disorder of skin and subcutaneous tissue, unspecified | General code for benign lesions when a more specific diagnosis is not available |
L72.0 | Epidermal cyst | Common benign subcutaneous lesion on trunk/arms/legs frequently removed by excision |
L50.9 | Urticaria, unspecified | Occasionally lesions mistaken for benign papules; rarely an indication for excision unless focal persisting lesion requires pathology |
D23.9 | Neoplasm of uncertain or unknown behavior of skin, unspecified | Used when lesion clinically benign but histology uncertain or for benign neoplasms removed for diagnosis or symptoms |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
17000 | Destruction (e.g., cryotherapy) of premalignant lesion (e.g., actinic keratosis); first lesion | Alternative or adjunct treatment when excision is not chosen; may be performed instead of 11400 for small noncancerous superficial lesions |
11100 | Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure, when performed); single lesion | Performed when initial approach is to obtain a diagnostic biopsy rather than a full excision; may precede 11400 if diagnosis uncertain |
12001 | Repair, simple, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less | Closure codes for simple repairs; if 11400 results in a wound requiring simple closure on trunk/limbs, appropriate repair code may be used if separate from excision coding rules |
11101 | Biopsy, single lesion, punch or shaving technique with tangential excision | Alternative biopsy technique that may be used before or instead of excision depending on lesion characteristics |
99024 | Postoperative follow-up visit global surgical package | Represents routine follow-up included in the global period; used when reporting post-op visits per payer rules |