Summary & Overview

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

CPT code 11622 represents the surgical excision of a malignant skin lesion, including margins, for lesions measuring 1.1 to 2.0 cm in diameter located on high-risk sites such as the scalp, neck, hands, feet, or genitalia. This procedure code is widely used across dermatology and surgical specialties and is important for tracking care, clinical outcomes, and payment for definitive tumor removal in outpatient and ambulatory surgical settings. Key national payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn the clinical context for the code, typical sites of service, how it maps to related excision codes for other lesion sizes, and where it sits within procedural billing for cutaneous malignancies. The publication provides benchmarks and common billing considerations for 11622, clarifies its relationship to adjacent size-based excision codes, and outlines typical clinical scenarios in which the code applies. This summary is designed to inform billing staff, clinicians, and policy analysts about the role of 11622 in surgical management of malignant skin lesions and to support consistent coding and reimbursement workflows nationally.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare11622CPTskin excisiondermatologic surgerymalignant lesionoutpatient surgeryprocedure codingoncologic dermatology

Billing Code Overview

CPT code 11622 describes the excision of a malignant skin lesion, including margins, measuring 1.1 to 2.0 cm in diameter. The service involves surgical removal of a cancerous lesion located on the scalp, neck, hands, feet, or genitalia.

Service type: Surgical excision for malignant cutaneous lesions.

Typical site of service: Hospital outpatient department, ambulatory surgery center, or physician office where minor surgical procedures are performed.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male presents to a dermatologic surgery clinic with a biopsy-proven malignant cutaneous lesion on the right scalp consistent with malignant melanoma (C43.61). The lesion measures 1.5 cm in greatest diameter on preoperative examination. The patient has controlled hypertension and is otherwise ambulatory. The dermatology surgeon reviews pathology, obtains informed consent, and schedules an outpatient excision under local anesthesia with monitored sedation as indicated. In the procedure room, the surgeon marks margins according to oncologic guidelines, administers local anesthetic, excises the lesion with appropriate peripheral and deep margins to achieve a total lesion specimen diameter falling in the 1.1–2.0 cm range, achieves hemostasis, and closes the defect primarily. The excised specimen is submitted to pathology for permanent section analysis. Postoperative instructions are provided, and the patient is scheduled for wound checks and discussion of final pathology.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the excision is performed on the left-sided anatomic area (for example, left scalp or left upper limb).
`RT`	Right side	Use when the excision is performed on the right-sided anatomic area (for example, right scalp or right upper limb).
`59`	Distinct procedural service	Use when another distinct, separate procedure is performed at the same session (for example, separate benign lesion excision billed separately) and documentation supports distinct services.
`25`	Data not available in the input.	Data not available in the input.
`50`	Bilateral procedure	Use when the same excision procedure is performed bilaterally, if applicable to paired sites.
`51`	Multiple procedures	Use when multiple procedures are performed at the same session in addition to the excision; list sequentially per payer rules.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as documented.
`53`	Discontinued procedure	Use when the procedure is terminated due to extenuating circumstances or those that threaten the patient's well-being.
`22`	Increased procedural services	Use when work required to perform the excision is substantially greater than typically required and supported by documentation.
`76`	Repeat procedure by same physician	Use when the same physician repeats the excision or a substantially related procedure during the postoperative period.
`77`	Data not available in the input.	Data not available in the input.
`TC`	Technical component	Use when billing only the technical component; often not applicable for a typical surgeon billing professional services.
`26`	Professional component	Use when billing only the professional component separate from a facility or technical component.
`59`	Distinct procedural service	Use when another distinct procedure at a separate anatomic site or separate encounter is performed and properly documented.

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Dermatologists commonly perform excisions of malignant skin lesions in office or outpatient surgical settings.
`207ND0101X`	MOHS-Micrographic Surgery	Mohs surgeons treat cutaneous malignancies; procedural approach may differ but taxonomy indicates expertise in skin cancer surgery.
`207Q00000X`	Family Medicine	Family physicians with procedural training may perform cutaneous excisions in office settings for malignant lesions.
`208600000X`	Surgery	General and surgical specialists perform excisions of malignant skin lesions, particularly in complex sites or when reconstruction is necessary.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C43.4`	Malignant melanoma of scalp and neck	Directly corresponds to malignant lesions in the scalp/neck region where `11622` may be reported when lesion size is 1.1–2.0 cm.
`C43.60`	Malignant melanoma of unspecified upper limb, including shoulder	Relevant when melanoma of the upper limb/shoulder is excised and falls within the `1.1–2.0 cm` size range for `11622`.
`C43.61`	Malignant melanoma of right upper limb, including shoulder	Used when the lesion is on the right upper limb; supports laterality reporting and appropriate coding.
`C43.62`	Malignant melanoma of left upper limb, including shoulder	Used when the lesion is on the left upper limb; supports laterality reporting and appropriate coding.
`C43.70`	Malignant melanoma of unspecified lower limb, including hip	Relevant for excisions on lower limbs when lesion size meets `11622` criteria.
`C43.71`	Malignant melanoma of right lower limb, including hip	Right-sided lower limb melanoma excisions that qualify for `11622`.
`C43.72`	Malignant melanoma of left lower limb, including hip	Left-sided lower limb melanoma excisions that qualify for `11622`.
`C4A.4`	Merkel cell carcinoma of scalp and neck	Merkel cell carcinoma is an aggressive cutaneous malignancy of the scalp/neck; excision with margins may be reported with `11622` when size criteria are met.
`C4A.60`	Merkel cell carcinoma of unspecified upper limb, including shoulder	Relevant when Merkel cell carcinoma of the upper limb is excised and meets the size threshold for `11622`.
`C4A.61`	Merkel cell carcinoma of right upper limb, including shoulder	Right-sided upper limb Merkel cell carcinoma supporting laterality for coding `11622`.
`C4A.62`	Merkel cell carcinoma of left upper limb, including shoulder	Left-sided upper limb Merkel cell carcinoma supporting laterality for coding `11622`.
`C4A.71`	Merkel cell carcinoma of right lower limb, including hip	Right lower limb Merkel cell carcinoma excisions that meet `11622` size criteria.
`C4A.72`	Merkel cell carcinoma of left lower limb, including hip	Left lower limb Merkel cell carcinoma excisions that meet `11622` size criteria.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11620`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less	Represents the smaller lesion size category; used when lesion diameter is ≤ 0.5 cm rather than `11622`.
`11621`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm	Represents the next smaller size category; used when lesion diameter falls between 0.6 and 1.0 cm.
`11622`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm	Primary code for this service when lesion diameter is within the stated range.
`11623`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm	Represents the next larger size category; used when lesion diameter is 2.1–3.0 cm.
`11624`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm	Represents a larger lesion size category requiring this higher-level code.
`11626`	Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm	Used when lesion diameter exceeds 4.0 cm and care complexity/effort increases accordingly.