Summary & Overview
CPT 11444: Excision of Benign Lesion on Face 3.1–4.0 cm
CPT code 11444 represents the surgical excision of a benign lesion located on cosmetically sensitive areas — the face, ears, eyelids, nose, lips, or mucous membrane — when the lesion measures greater than 3.0 cm and up to 4.0 cm in diameter and is closed with a simple (nonlayered) technique. This procedure is routinely performed in outpatient settings, ambulatory surgical centers, and physician offices and is significant nationally because it addresses common dermatologic and soft-tissue lesions where cosmetic and functional outcomes are important.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find practical context on the clinical scenario that triggers use of CPT code 11444, typical sites of service, and how this code fits within surgical excision coding for benign lesions. The publication provides benchmarks and coding context, highlights relevant policy and coverage considerations, and clarifies clinical descriptors that distinguish this code from adjacent excision codes for smaller or larger lesion sizes or more complex closures.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 11444 describes surgical excision of a benign (noncancerous) lesion on cosmetically sensitive areas — specifically the face, ears, eyelids, nose, lips, or mucous membrane — with a lesion diameter greater than 3.0 cm and up to 4.0 cm, followed by a simple (nonlayered) closure.
-
Service type: Surgical excision of benign lesion with simple closure
-
Typical site of service: Outpatient surgical setting, ambulatory surgery center, or physician office procedure room where minor excisions on the face, ears, eyelids, nose, lips, or mucous membrane are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to a dermatology clinic with a longstanding, benign-appearing nevus on the left cheek measuring approximately 3.5 cm in greatest diameter. The lesion is symptomatic with intermittent irritation and the patient requests removal for cosmetic reasons. The dermatologist performs a full-thickness excision of the lesion with appropriate margins under local anesthesia in an outpatient procedure room and closes the wound with a simple (nonlayered) linear closure.
The clinical workflow includes: pre-procedure evaluation and informed consent, lesion marking and local infiltration with anesthetic, excision of the lesion including margins, specimen labeling and submission to pathology if indicated, hemostasis, irrigation, and simple skin closure with sutures. Post-procedure instructions and follow-up for suture removal are provided. Billing is reported with 11444 for excision of a benign lesion 3.1 to 4.0 cm on the face with simple closure. Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA plans, and Medicare. Typical site of service is an outpatient dermatology clinic, ambulatory surgical center, or physician office procedure room.
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 the same day as 11444 (note: 25 was not in the provided modifiers list; follow input list—see selected modifiers below). |
26 | Professional component | Use if billing only the professional component of a service that has professional and technical components (rare for simple excision but applicable if separate technical component exists). |
50 | Bilateral procedure | Use when identical procedures are performed on both sides of the face during the same operative session. |
51 | Multiple procedures | Use when 11444 is reported together with other distinct procedures on the same date by the same provider; report additional procedure codes with modifier 51 as appropriate. |
52 | Reduced services | Use when the service is partially reduced or not completed at the provider's discretion. |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances or beyond the provider's control. |
59 | Distinct procedural service | Use to indicate a procedure or service that was distinct or independent from other services performed on the same day. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct parts of the procedure. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use for return to the OR for complications related to the initial 11444 procedure. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period of 11444. |
LT | Left side | Use to indicate the procedure was performed on the left side of the body when laterality reporting is required. |
RT | Right side | Use to indicate the procedure was performed on the right side of the body when laterality reporting is required. |
GC | Service performed in part by a resident under the direction of a teaching physician | Use when a teaching physician documents and supervises resident-performed portions of the procedure per applicable rules. |
TC | Technical component | Use when billing only the technical component of a service (rare for excisions but used when applicable). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Dermatologists most commonly perform benign skin lesion excisions on the face. |
207P00000X | Plastic Surgery | Plastic surgeons perform excisions and closures when reconstruction or complex closure is anticipated. |
2080P0005X | Otolaryngology (ENT) | ENT surgeons perform excisions on facial subunits including nose and perioral areas when anatomy or airway considerations apply. |
363L00000X | General Surgery | General surgeons may perform excisions in ambulatory surgical centers for appropriate facial lesions. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L82.0 | Seborrheic keratosis | Common benign epidermal lesion that may be excised on the face for irritation or cosmetic concerns. |
D23.9 | Other benign neoplasm of skin, unspecified | General category for benign skin neoplasms excised with 11444 when site and type are not further specified. |
D22.9 | Melanocytic nevi, unspecified | Common benign nevus that may require removal for cosmetic or symptomatic reasons. |
L70.0 | Acne vulgaris | Included when excision addresses sequelae or cystic nodules that may be surgically managed (less common). |
L91.8 | Other hypertrophic and atrophic conditions of skin | Scars or hypertrophic lesions on the face may be treated with excision. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11400 | Excision, benign lesion including margins; face, ears, eyelids, nose, lips, mucous membranes; diameter 0.5 cm or less | Smaller-size counterpart to 11444 used when lesion diameter is 0.5 cm or less. |
11446 | Excision, benign lesion including margins; face, ears, eyelids, nose, lips, mucous membrane; diameter 4.1 cm to 5.0 cm | Larger-size banding for benign lesion excisions on the face when lesion exceeds 11444 size range. |
12032 | Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm | Represents layered closure complexity; used when a layered (intermediate) repair is performed instead of the simple closure included in 11444. |
13131 | Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm | Used when complex repair is required after excision instead of the simple closure included in 11444. |
88305 | Level IV surgical pathology, gross and microscopic examination | Used when excised tissue from 11444 is submitted for pathology evaluation. |
17000 | Destruction (eg, laser, electrosurgery, cryotherapy) of benign lesions, up to 14 lesions | Alternative to excision when lesion destruction is chosen instead of surgical removal. |