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CPT 11601: Excision of Malignant Skin Lesion, Trunk/Arms/Legs (0.6–1.0 cm)
CPT code 11601 denotes the surgical excision of a malignant skin lesion, including margins, for lesions measuring 0.6 to 1.0 cm or less on the trunk, arms, or legs. This code is commonly used in dermatologic and general surgical practice for definitive treatment of small cutaneous malignancies and is important for accurate clinical documentation and claims processing nationwide. Proper coding ensures alignment of clinical intent with billing and supports quality measurement for skin cancer care.
The analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of payer coverage patterns and typical billing considerations, comparisons to closely related excision codes for other lesion sizes and anatomic sites, and clinical context about the procedure’s role in management of localized skin malignancies. The publication also summarizes applicable diagnosis mappings and relevant surgical specialties that commonly report this service.
Intended for coding professionals, clinicians, and policy analysts, the content clarifies the clinical definition of the service represented by 11601, highlights the typical settings where it is performed, and outlines what readers can expect in the full report regarding benchmarks, code relationships, and payer policy considerations. Data not available in the input for specific rate tables or payer edits.
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Billing Code Overview
CPT code 11601 describes the surgical excision of a malignant skin lesion (including margins) measuring 0.6 to 1.0 cm or less in diameter. The procedure removes the cancerous lesion and surrounding tissue to achieve clear margins.
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Service type: Surgical excision of malignant cutaneous lesion
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Typical site of service: Skin of the trunk, arms, or legs
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.