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CPT 11603: Excision of Malignant Skin Lesion, Trunk/Arms/Legs 2.1–3.0 cm
CPT code 11603 denotes the excision of a malignant skin lesion, including margins, with a lesion diameter of 2.1 to 3.0 cm from the trunk, arms, or legs. This code captures a common dermatologic and surgical oncology procedure used to treat invasive skin cancers and is important for reimbursement, quality reporting, and procedural tracking across ambulatory and hospital outpatient settings. Nationally, accurate coding for lesion size and anatomic site is critical to ensure appropriate payment and to support clinical registry and surveillance activities.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication provides a concise review of code definition and clinical context, payer coverage considerations, common billing modifiers and associated provider taxonomies, mapping to representative ICD-10 diagnoses, and closely related CPT codes used for smaller lesion sizes. Readers will find benchmarks and policy-relevant notes that clarify typical use cases, compare 11603 to adjacent codes 11602 and 11600, and summarize documentation elements that influence coding selection. The material is presented for a national audience to support coding accuracy, claims processing, and clinical documentation alignment for oncologic skin excisions.
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Billing Code Overview
CPT code 11603 describes the surgical excision of a malignant skin lesion, including margins, with a lesion diameter of 2.1 to 3.0 cm. The procedure is performed on the skin of the trunk, arms, or legs and involves removal of the cancerous tissue to achieve appropriate oncologic margins.
Service Type: Surgical excision of malignant cutaneous lesion
Typical Site of Service: Outpatient surgical setting, ambulatory surgery center, or hospital outpatient department (skin of trunk, arms, or legs)
National Reimbursement Benchmarks
Medicare’s mean payment of $285.50 sits well below BUCA’s average commercial mean of $925.10, reflecting a substantial gap between public and that commercial benchmark. This divergence highlights how Medicare’s nationwide reimbursement is more conservative compared with the higher commercial average represented by BUCA, with Medicare clustering around its central locality measures ($268–$296 interquartile band) versus BUCA’s higher central tendency ($736.80–$1,143.50).
Assessing dispersion (P75 minus P25) across payers, Blue Cross Blue Shield shows one of the widest IQRs at $544.30 ($1,688.70–$1,144.40), while Aetna’s IQR is $170.00 ($259.00–$89.00), indicating tighter clustering for Aetna. UnitedHealth Group’s IQR is $245.00 ($520.00–$257.50), Cigna’s IQR is $236.30 ($470.70–$233.40), and BUCA’s IQR is $407.70 ($1,143.50–$736.80). Medicare’s IQR is narrow at $28.00 ($296–$268).