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CPT 11621: Excision of Malignant Skin Lesion, 0.6–1.0 cm
CPT code 11621 denotes surgical excision of a malignant skin lesion, including margins, for lesions measuring 0.6 to 1.0 cm in diameter in anatomically sensitive sites such as the scalp, neck, hands, feet, or genitalia. This code is commonly used in dermatologic and surgical oncology practice and matters nationally because it standardizes billing for a frequently performed cancer-directed procedure that carries implications for quality measurement, coding accuracy, and reimbursement consistency across payers. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.
Readers will find a concise overview of clinical context and coding parameters for 11621, comparisons to adjacent size-based excision codes, and the payer landscape informing coverage and administrative considerations. The publication summarizes benchmarks for billing frequency and common service settings, highlights coding relationships to nearby CPT codes for different lesion sizes, and presents policy and coding issues that affect claim adjudication and documentation practices. This national-level briefing is intended to clarify the clinical scope of the code, outline the primary payer coverage universe, and orient readers to the operational and policy dimensions relevant to managing claims for excision of small malignant cutaneous lesions.
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Billing Code Overview
CPT code 11621 describes the surgical excision of a malignant skin lesion, including margins, with a lesion diameter of 0.6 to 1.0 cm. The procedure involves removal of the cancerous lesion from anatomically sensitive or functionally important regions.
Service type: Surgical excision of malignant cutaneous lesion
Typical site of service: Skin of the scalp, neck, hands, feet, or genitalia (sex organs)
National Reimbursement Benchmarks
Commercial averages trend notably above Medicare for CPT 11621: Blue Cross Blue Shield’s mean at $774 and BUCA’s mean at $551.20 sit well above Medicare’s mean of $236.50, indicating that commercial contracts generally reimburse substantially more than Medicare for this code. Blue Cross Blue Shield’s unusually high max and wide upper percentiles push its mean up, while UnitedHealth Group and Cigna also average above Medicare at $329.30 and $304.70 respectively, highlighting a multi-payer commercial premium over the Medicare baseline.
Dispersion varies markedly by payer. Calculating the interquartile spread (P75 minus P25) yields the tightest distributions for Aetna (IQR $142.00) and Cigna (IQR $195.60), while the widest spreads appear for Blue Cross Blue Shield (IQR $316.60) and UnitedHealth Group (IQR $159.00). BUCA’s IQR is $234.20 and Medicare’s IQR is $25.00, showing Medicare payments are comparatively concentrated around the median.