CPT 11601: Excision of Malignant Skin Lesion, Trunk/Arms/Legs, 0.6–1.0 cm
Medicare pays $235 and commercial payers pay $553 on average nationally for this procedure.
CPT code 11601 describes surgical excision of a malignant skin lesion, including margins, measuring greater than 0.5 cm up to 1.0 cm in diameter from the trunk, arms, or legs; service type: excision of malignant lesion (skin cancer surgery); typical site of service: ambulatory surgery center or outpatient clinic/procedure room.
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National Reimbursement Benchmarks
Medicare’s mean of $235.10 sits below BUCA’s average commercial mean of $552.70, indicating that BUCA reimbursements are, on average, roughly $317.60 higher than Medicare for CPT 11601. This gap highlights a common pattern where certain commercial channels pay substantially more than the federal program for the same code.
Dispersion varies notably by payer. Blue Cross Blue Shield shows the widest interquartile spread with P75–P25 = $333.80, followed by UnitedHealth Group at $117.70 and Cigna at $197.30; Aetna’s spread is $140.60 and BUCA’s is $240.60. The tightest IQR is UnitedHealth Group? Wait: compute correctly: UnitedHealth Group p75 $416.40 minus p25 $204.70 = $211.70; Cigna p75 $385.80 minus p25 $188.50 = $197.30; Aetna p75 $196.10 minus p25 $51.50 = $144.60; BUCA $685.10 minus $424.50 = $260.60; Blue Cross Blue Shield $949.40 minus $631.60 = $317.80. Thus Blue Cross Blue Shield is widest and Aetna is tightest.