Summary & Overview
CPT 11442: Excision of Benign Lesion on Face 1.1–2.0 cm
CPT code 11442 denotes the surgical excision of a benign skin lesion on cosmetically sensitive areas (face, ears, eyelids, nose, lips, or mucous membrane) measuring 1.1 to 2.0 cm with a simple, nonlayered closure. This code matters nationally because procedures in cosmetically and functionally important anatomic sites often carry distinct clinical considerations and billing practices that affect pricing, utilization, and prior authorization patterns across payers.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find information on what the code represents clinically, standard sites of service, common payer coverage frameworks, and the typical service context for dermatology and surgical practices.
This publication provides a concise clinical and billing context for CPT code 11442, outlines where the service is commonly performed, and summarizes common modifiers and payer considerations used in practice. Data not available in the input is indicated explicitly where relevant. The content is intended for billing managers, clinicians, and policy analysts seeking a clear overview of the code’s clinical meaning, operational setting, and payer landscape at a national level.
Billing Code Overview
CPT code 11442 describes excision of a benign (noncancerous) lesion on the face, ears, eyelids, nose, lips, or mucous membrane measuring 1.1 to 2.0 cm in diameter. The procedure includes removal of the lesion with margins and a simple (nonlayered) closure of the resultant wound.
-
Service type: Surgical excision of benign cutaneous lesion with simple closure
-
Typical site of service: Ambulatory surgical center, hospital outpatient department, or physician office procedure suite, typically performed by dermatology, plastic surgery, or otolaryngology providers
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an outpatient dermatology clinic with a slowly enlarging, benign-appearing nevus on the left cheek measuring approximately 1.5 cm in greatest diameter. After clinical evaluation and shared decision-making, the dermatologist schedules an excision in the minor procedure room. The procedure workflow includes verification of consent, local anesthesia (typically lidocaine with epinephrine), marking of margins, elliptical excision of the lesion with appropriate margins, hemostasis, and a simple (nonlayered) linear closure using interrupted or running sutures. Specimen is labeled and sent to pathology if indicated. Typical site of service is an ambulatory surgery center or office-based procedure room; occasionally performed in a hospital outpatient department for patients with comorbidities or anticoagulation concerns. Common documentation elements include lesion location and size (measured after excision), indication (benign lesion), technique (excision with simple closure), anesthesia used, estimated blood loss, and specimen handling.
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 day as the excision |