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    OpenPayerBilling CodesExcision-Malignant Lesions Procedures on the SkinCPT cpt-11601-excision-malignant-lesion-trunk-arms-legs-0-6-1-0-cm
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    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.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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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.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient presents to a dermatology clinic with a 0.8 cm pigmented lesion on the lateral forearm that was previously biopsied and diagnosed as melanoma in situ. The patient is medically stable with no anticoagulation issues and requests definitive excision. The clinical workflow includes preoperative evaluation and informed consent, marking lesion and planned margins, local anesthesia (typically lidocaine with epinephrine), full-thickness excision of the lesion with margins appropriate for an in situ melanoma, hemostasis, layered closure of the defect, and specimen orientation and submission to surgical pathology. Postoperative instructions and a wound-care plan are provided, with follow-up scheduled to assess healing and pathology results. The procedure is performed in an outpatient dermatology or ambulatory surgical center setting under local anesthesia. Typical payer interactions include verification of coverage with Blue Cross Blue Shield, Aetna, Cigna Health, UnitedHealthcare, BUCA, and Medicare prior to scheduling.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11600Excision, malignant lesion including margins, trunk, arms, or legs; lesion diameter excised 0.5 cm or lessAlternative size-specific code for very small malignant lesions on trunk/limbs; used when lesion diameter fits that range.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    57CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207N00000X
    207ND0101X
    208600000X
    106E00000X
    246QH0401X
    226000000X
    225XP0019X
    163WN0002X

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-11600-EXCISION-MALIGNANT-LESION-05-CM-TRUNK-ARMS-LEGS

    CPT 11600: Excision of Malignant Lesion, ≤0.5 cm, Trunk/Arms/Legs

    CPT-11602-EXCISION-MALIGNANT-LESION-TRUNK-ARMS-LEGS-1-1-2-0CM

    CPT 11602: Excision of Malignant Lesion, Trunk/Arms/Legs 1.1–2.0 cm

    CPT-11603-EXCISION-MALIGNANT-LESION-TRUNK-ARMS-LEGS-2-1-3-0-CM

    CPT 11603: Excision of Malignant Lesion, Trunk/Arms/Legs 2.1–3.0 cm

    CPT-11604-EXCISION-MALIGNANT-LESION-TRUNK-ARMS-LEGS-3-1-4-0-CM

    CPT 11604: Excision of Malignant Lesion, Trunk/Arms/Legs 3.1–4.0 cm

    CPT-11606-EXCISION-MALIGNANT-LESION-TRUNK-ARMS-LEGS-OVER-4CM

    CPT 11606: Excision of Malignant Skin Lesion >4.0 cm on Trunk/Arms/Legs

    CPT-11620-EXCISION-MALIGNANT-SKIN-LESION-SMALL-DIAMETER-SCALP-NECK-HANDS-FEET-GENITALIA

    CPT 11620: Excision of Malignant Skin Lesion, ≤0.5 cm

    CPT-11621-EXCISION-MALIGNANT-LESION-06-10-MM-SCALP-NECK-HANDS-FEET-GENITALIA

    CPT 11621: Excision of Malignant Skin Lesion, 0.6–1.0 cm

    CPT-11622-EXCISION-MALIGNANT-LESION-1-1-TO-2CM-SCALP-NECK-HANDS-FEET-GENITALIA

    CPT 11622: Excision of Malignant Skin Lesion 1.1–2.0 cm

    CPT-11623-EXCISION-MALIGNANT-SKIN-LESION-2-1-3CM-SCALP-NECK-HANDS-FEET-GENITALIA

    CPT 11623: Excision of Malignant Lesion, 2.1–3.0 cm, Scalp/Neck/Hands/Feet/Genitalia

    CPT-11624-EXCISION-MALIGNANT-LESION-3-1-TO-4-0-CM-SCALP-NECK-HANDS-FEET-GENITALIA

    CPT 11624: Excision of Malignant Skin Lesion, 3.1-4.0 cm

    Showing 1–10 of 17

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    11602
    Excision, malignant lesion including margins, trunk, arms, or legs; lesion diameter excised 1.1 to 2.0 cm
    Used when the excised malignant lesion on trunk/limb is larger than the 0.6 to 1.0 cm range in 11601.
    11603Excision, malignant lesion including margins, trunk, arms, or legs; lesion diameter excised 2.1 to 3.0 cmUsed when lesion size exceeds the 11601 range and requires a higher-level size code.
    11604Excision, malignant lesion including margins, trunk, arms, or legs; lesion diameter excised 3.1 to 4.0 cmUsed for larger malignant lesions on trunk/limbs beyond 11601 size limits.
    11606Excision, malignant lesion including margins, trunk, arms, or legs; lesion diameter excised 4.1 cm or greaterUsed when lesion size is substantially larger than allowed in 11601.
    11640Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 0.5 cm or lessRelated face/head region codes; select when anatomic site is face/ears rather than trunk/limbs.
    11641Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 0.6 to 1.0 cmFace/head size-equivalent for 11601 when lesion is on the face.
    11642Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 1.1 to 2.0 cmUsed for larger lesions on face/ears beyond the 11641 range.
    11643Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 2.1 to 3.0 cmHigher size category for face/head lesions compared with 11601 site.
    11644Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 3.1 to 4.0 cmLarger face/head lesion code; relevant when site affects code selection.
    11646Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; lesion diameter excised 4.1 cm or greaterFor very large malignant lesions on the face/ears requiring extensive excision; differentiates by site and size.