Summary & Overview

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

CPT code 11606 designates the excision of a malignant skin lesion greater than 4.0 cm in diameter from the trunk, arms, or legs, including removal of margins. The code is used in surgical oncology and dermatologic practices to report definitive removal of large cutaneous malignancies and has implications for surgical planning, postoperative care, and billing workflows nationwide. Key payers in national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

This publication provides a concise reference for clinicians, billing staff, and policy analysts. Readers will find: a clear definition of the clinical service represented by CPT code 11606; the typical sites of service and service type; an overview of common related procedure codes and diagnostic associations; and the list of major payers relevant to coverage and claims processing. The content summarizes coding context needed for accurate claim submission and aligns clinical description with administrative reporting. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 11606excision malignant lesiondermatologic surgerysurgical oncologyskin cancer billingprocedure codingoutpatient surgeryoperative report

Billing Code Overview

CPT code 11606 describes the surgical excision of a malignant skin lesion, including margins, larger than 4.0 cm in diameter, located on the trunk, arms, or legs. This is an operative dermatologic procedure performed to remove cancerous skin lesions and obtain clear margins.

Service type: Surgical excision of malignant lesion

Typical site of service: Outpatient surgical suite, ambulatory surgery center, or hospital outpatient department

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents to a dermatologic surgical clinic with a biopsy-proven malignant melanoma on the lateral trunk measuring clinically about 4.5 cm in greatest diameter. The lesion is located on the skin of the torso, with irregular borders and suspected deep extension; preoperative evaluation includes review of prior biopsy pathology, medical history, medication reconciliation, and discussion of risks, benefits, and alternatives. On the day of service the patient is placed in a minor procedure suite or ambulatory surgery center; local anesthesia with monitored sedation or general anesthesia is provided per anesthetic risk and patient preference. The surgeon performs wide local excision of the malignant lesion with appropriate surgical margins, documents the lesion size and final excised specimen diameter (greater than 4.0 cm), closes the defect by direct layered closure or flap/graft if needed, and sends the specimen for permanent pathology. Postoperative instructions, wound care, and follow-up for pathology review and oncologic staging are arranged.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing separately for the physician’s professional interpretation or service when a global technical component is billed by another provider or facility.
`50`

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Dermatologists commonly perform excisions of malignant skin lesions on trunk and extremities.
`207ND0101X`	MOHS-Micrographic Surgery	MOHS surgeons focus on margin-controlled excision; may participate when margin assessment is required.
`208600000X`	Surgery	General or surgical oncologists perform wide local excisions for larger cutaneous malignancies when reconstruction or oncologic management is needed.

ICD-10 Code	Description	Clinical Relevance
`C43.51`	Malignant melanoma of anal skin	Indicates melanoma on the anal region of the trunk; may require wide excision if located on skin of the trunk.
`C43.52`	Malignant melanoma of skin of breast	Melanoma on breast skin falls under trunk-site excisions and may be managed with wide local excision.
`C43.59`	Malignant melanoma of other part of trunk	Generic trunk-site melanoma diagnosis directly aligned with excision of lesions >4.0 cm on the trunk.
`C43.60`	Malignant melanoma of unspecified upper limb, including shoulder	Melanoma of the upper limb/shoulder corresponds to excisions on arms or shoulder areas described by the procedure code.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10060`	Incision and drainage of abscess; simple or single	May be performed preoperatively if infected or purulent lesion requires drainage prior to definitive excision.
`10061`	Incision and drainage of abscess; complicated or multiple	Used for complex abscess drainage that might precede or complicate excisional planning.
`11200`	Removal of skin tags, multiple fibro-epithelial tags up to 15 lesions	Performed for benign superficial lesions during the same visit but typically reported separately.
`11201`	Removal of skin tags, each additional 10 lesions	Add-on for multiple benign lesion removals performed with excision.
`17260`	Destruction of premalignant lesion(s); area over 4.0 sq cm, first lesion	May be an alternative for superficial lesions but not appropriate for invasive melanoma; listed for context in procedural planning.
`17261`	Destruction of premalignant lesion(s); area over 4.0 sq cm, second through 14th lesion	Additional lesion destruction codes when multiple actinic keratoses are treated.
`17262`	Destruction of premalignant lesion(s); each additional 10 lesions	Further add-on for multiple lesions.
`17263`	Destruction of premalignant lesion(s); each additional 25 lesions	As above for lesion counts.
`17264`	Destruction of premalignant lesion(s); first lesion, trunk, arms, or legs	Contextual code for lesion destruction on similar anatomic sites.
`17266`	Destruction of premalignant lesion(s); each additional lesion	Add-on for multiple lesions when destruction is performed.
`17270`	Destruction, malignant lesion(s), trunk, arms, or legs; lesion diameter 0.5 cm or less	For smaller malignant lesion destruction when excision is not performed.
`17271`	Destruction, malignant lesion(s), trunk, arms, or legs; lesion diameter 0.6 to 1.0 cm	Size-based destruction codes adjacent to excision codes.
`17272`	Destruction, malignant lesion(s), trunk, arms, or legs; lesion diameter 1.1 to 2.0 cm	Larger-diameter lesion destruction options.
`17273`	Destruction, malignant lesion(s), trunk, arms, or legs; lesion diameter 2.1 to 3.0 cm	Continued size gradation for destructive procedures.
`17274`	Destruction, malignant lesion(s), trunk, arms, or legs; lesion diameter 3.1 to 4.0 cm	Near-size comparator to excision codes.

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