Summary & Overview
CPT 11450: Excision of Axillary Skin and Subcutaneous Tissue for Hidradenitis
CPT code 11450 represents the surgical excision of axillary skin and subcutaneous tissue for hidradenitis with closure using simple or intermediate repair techniques. This code is used to bill for definitive surgical management of painful, recurrent axillary lesions often related to hidradenitis suppurativa. Nationally, accurate coding for this procedure matters for documenting surgical treatment, capturing resource use, and ensuring alignment between clinical intent and billed services.
Key payers commonly involved in coverage decisions for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical sites of service, and common billing considerations. The publication provides benchmarks for utilization and reimbursement patterns, highlights recent policy clarifications or payer guidance where applicable, and summarizes clinical indications relevant to coding choices.
This summary is intended for clinicians, coding professionals, and policy analysts seeking a national-level overview of CPT code 11450, its clinical application, and the payer landscape. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 11450 describes excision of axillary skin and subcutaneous tissue for hidradenitis with closure using simple or intermediate repair techniques. The service type is surgical excision of axillary skin and subcutaneous tissue for hidradenitis. The typical site of service is an operating room or procedure suite in an outpatient surgical setting, often performed by dermatologic or surgical specialists.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 32-year-old patient presents with recurrent, painful, inflamed nodules and sinus tracts in the left axilla consistent with hidradenitis suppurativa refractory to medical therapy. After failed conservative measures including antibiotics, intralesional corticosteroid injections, and topical care, the patient is scheduled for an outpatient excision of affected axillary skin and subcutaneous tissue with primary closure using simple or intermediate repair techniques. The procedure is performed in an ambulatory surgical center under local anesthesia with monitored sedation. Preoperative workflow includes informed consent, marking of the excision margins, sterile prep, and local anesthesia infiltration. Intraoperative steps include excision of diseased skin and subcutaneous tissue down to healthy margins, hemostasis, layered closure with simple or intermediate repair, and application of a sterile dressing. Postoperative workflow includes recovery monitoring, wound care instructions, pain management plan, and follow-up visit for wound check and suture removal.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Professional component | Use when reporting the physician's professional work separate from facility or technical component (rare for simple excisions billed by facility). |
22 | Increased procedural services | Use when the excision required substantially greater service than typical (extensive scar tissue, difficult hemostasis) with documentation. |
23 | Unusual anesthesia | Use when general anesthesia or major regional block was required for a procedure normally done under local anesthesia. |
50 | Bilateral procedure | Use when equal or comparable excisions are performed on both axillae. |
51 | Multiple procedures | Use when additional unrelated procedures are performed during the same operative session. |
52 | Reduced services | Use when the procedure was partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure was started but terminated due to extenuating circumstances or patient safety concerns. |
59 | Distinct procedural service | Use to indicate a distinct procedural service when services may be bundled; document separate anatomic sites or distinct session. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the excision/repair. |
80 | Assistant surgeon | Use when an assistant surgeon provides surgical assistance during the excision. |
21 | Data not in provided list | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Dermatology | Dermatologic surgeons frequently perform excisions for hidradenitis. |
207L00000X | Plastic Surgery | Plastic surgeons perform excision with complex closures or reconstructive needs. |
207M00000X | General Surgery | General surgeons may perform axillary excisions in more severe or extensive disease. |
208000000X | Family Medicine | Family physicians with procedural skills in skin surgery may perform limited excisions. |
207X00000X | Otolaryngology | Otolaryngologists occasionally perform skin and subcutaneous excisions in the head and neck region; less common for axilla but included as a potential specialty. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L73.2 | Hidradenitis suppurativa | Primary diagnosis for excision of axillary skin and subcutaneous tissue due to recurrent painful lesions and sinus tracts. |
L02.419 | Cutaneous abscess of unspecified axilla | Relevant when acute abscess formation prompts incision, drainage, or excision of infected tissue. |
L98.49 | Other specified disorders of skin and subcutaneous tissue | Used when specific descriptors of chronic or recurrent skin conditions are required but not otherwise classified. |
B95.61 | Methicillin resistant Staphylococcus aureus as the cause of disease classified elsewhere | Relevant when MRSA is identified as the infectious agent complicating hidradenitis and may affect perioperative management. |
T81.4XXA | Infection following a procedure, initial encounter | Used postoperatively if surgical site infection occurs requiring additional care. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11043 | Debridement, muscle and/or fascia, first 20 sq cm or less | May be used if deeper debridement of infected tissue involving fascia or muscle is required prior to closure. |
12031 | Repair, intermediate, wounds of scalp, axilla, trunk and/or extremities; 2.6 cm to 7.5 cm | Used when closure meets intermediate repair definitions for layered closure of the excision site. |
12001 | Repair, simple, superficial wounds of scalp, neck, axilla, trunk and/or extremities; 2.5 cm or less | Used when the excision defect is closed with a simple repair within specified size limits. |
13131 | Repair, complex, trunk, arms, or legs; 1.1 cm to 2.5 cm | Used when closure requires complex repair techniques beyond simple or intermediate repair. |
11400 | Excision, benign lesion including margins, trunk, arms or legs; lesion diameter 0.5 cm or less | Related for coding excisions of benign skin lesions when procedure limited to lesion excision rather than hidradenitis excision. |
10140 | Incision and drainage of pilonidal cyst; simple | May be performed prior to or instead of excision for acute fluctuant abscesses in hidradenitis management. |