Summary & Overview

CPT 11424: Excision of Benign Skin Lesion 3.1–4.0 cm

CPT code 11424 identifies the surgical excision of a benign (noncancerous) skin lesion, excluding skin tags, measuring 3.1 to 4.0 cm in diameter, including margins. This code is relevant nationally for dermatology, general surgery, and procedural billing workflows because it standardizes reporting for moderate-size lesion removals on anatomically sensitive sites such as the scalp, neck, hands, feet, and genitals. Accurate use of this code affects claim adjudication, procedure tracking, and quality reporting for outpatient surgical services.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides readers with an overview of clinical context for excision of benign lesions, typical sites of service, and operational considerations tied to billing and coding. It also outlines common modifiers used with the code and highlights related reimbursement and documentation topics where applicable.

Readers will learn how CPT code 11424 maps to the clinical procedure (size-based excision), what payer coverage is typically considered in national comparisons, and which operational benchmarks and policy issues tend to affect use of the code. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare11424CPTskin-excisiondermatologic-surgeryoutpatient-procedurebenign-lesionprocedure-codingsurgical-excision

Billing Code Overview

CPT code 11424 describes the surgical excision of a noncancerous skin lesion (excluding skin tags) with a diameter of 3.1 to 4.0 cm, including margins. The procedure involves removal of the lesion and surrounding tissue to ensure complete excision of the benign growth.

Service type: Surgical excision of benign skin lesion
Typical site of service: Scalp, neck, hands, feet, or genitals

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient presents to a dermatologic surgery clinic with a solitary, well-circumscribed, noncancerous cutaneous lesion on the dorsal hand measuring approximately 3.5 cm including clinical margins. The lesion has been symptomatic with intermittent irritation and has failed conservative management. The dermatologist documents history, relevant medications, informed consent, and performs a focused preoperative assessment. The procedure performed is an excision of a benign skin lesion of 3.1–4.0 cm diameter from the hand using local anesthesia. The excised specimen is oriented, measured, and submitted for pathology when indicated. Postoperative care includes hemostasis, layered closure or skin approximation, application of dressing, and instructions for wound care and follow-up for suture removal and pathology review.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when a distinct E/M visit is performed and documented on the same date as the excision.
`22`	Increased procedural services	Use when the work or complexity of the excision is substantially greater than typical and documentation supports unusual effort.
`52`	Reduced services	Use when the excision is partially reduced or not completed as billed and documentation explains the reduction.
`53`	Discontinued procedure	Use when the procedure is started but discontinued for clinical reasons; documentation must explain why.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure or site when bundling edits might apply.
`24`	Unrelated E/M service by the same physician during a postoperative period	Use when an E/M visit unrelated to the excision occurs during the global period.
`54`	Surgical care only	Use when only the surgeon’s intraoperative portion is billed and another provider bills postoperative care.
`55`	Postoperative management only	Use when only postoperative care is billed by the surgeon.
`RT`	Right side	Use to designate procedures performed on the right side when laterality reporting is required.
`LT`	Left side	Use to designate procedures performed on the left side when laterality reporting is required.
`TC`	Technical component	Use when billing only the technical component of a service (rare for excisions; applies if facility bills separately).
`26`	Professional component	Use when billing only the professional component of a service (rare for excisions; applies if professional and technical components are split).
`50`	Bilateral procedure	Use when the same excision is performed bilaterally and payer accepts bilateral modifier rules.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period and documentation supports it.

Taxonomy Code	Specialty	Notes
207L00000X	Dermatology	Dermatologists commonly perform benign skin lesion excisions on scalp, neck, hands, feet, or genitals.
208000000X	General Surgery	General surgeons perform skin and soft tissue excisions in operative settings.
2083P0001X	Plastic Surgery	Plastic surgeons perform excisions with complex closures or reconstructive planning.
2086S0122X	Otolaryngology (ENT)	ENT physicians may excise lesions on the scalp or neck when indicated.
261Q00000X	Podiatry	Podiatrists perform excisions on the foot when the lesion is located there.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L91.8`	Other hypertrophic disorders of skin	May apply to benign raised lesions requiring excision for symptomatic relief or cosmetic reasons.
`L98.9`	Disorder of the skin and subcutaneous tissue, unspecified	General code when a specific benign lesion diagnosis is not documented; use with caution.
`D22.9`	Melanocytic nevus, unspecified	Common benign lesion (nevus) that may be excised for diagnostic or cosmetic reasons.
`D23.9`	Other benign neoplasm of skin, unspecified	Frequently used for benign skin tumors such as lipomas, epidermal inclusion cysts, or other neoplasms.
`L92.9`	Granulomatous disorder of skin and subcutaneous tissue, unspecified	Applies when lesion is granulomatous and requires excision for diagnosis or treatment.
`L91.0`	Hypertrophic scar	Applies when excision is performed for symptomatic or cosmetic hypertrophic scars.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12002`	Simple repair of superficial wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm	May be reported for layered closure or simple repair following excision when appropriate and documentation differentiates the excision from the repair.
`11102`	Tangential biopsy of skin (shave), single lesion	Performed as an initial diagnostic biopsy prior to definitive excision for an uncertain lesion.
`88305`	Level IV surgical pathology, gross and microscopic examination	Commonly reported when the excised benign specimen is submitted for histopathologic evaluation.
`13131`	Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm	Used when the closure of the excision requires complex layered repair, undermining, or flaps.
`17000`	Destruction (e.g., laser surgery, electrosurgery, cryosurgery) of benign lesion other than skin tag; first lesion	Alternative modality for treatment of benign lesions when excision is not performed.