Summary & Overview
CPT 11624: Excision of Malignant Skin Lesion, 3.1–4.0 cm
CPT code 11624 denotes the surgical excision of a malignant skin lesion with margins for lesions measuring 3.1 to 4.0 cm in diameter, performed on anatomically sensitive areas such as the scalp, neck, hands, feet, or genitalia. This code is a key surgical oncology CPT descriptor used nationwide for reporting and payment of wide local excisions of skin cancers in high-complexity anatomical sites. Accurate use of this code affects clinical documentation, billing integrity, and aggregate national procedure counts for dermatologic and surgical oncology care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for typical reimbursement and utilization patterns, coding guidance context, and clinical considerations tied to lesion size and anatomic location. The content also summarizes common modifiers in use and notes where additional coding detail or documentation is frequently required.
This publication provides a concise reference to the clinical scope of CPT code 11624, its role in surgical dermatology and oncology practice, and the payer landscape that influences coding and billing. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 11624 describes the surgical excision of a malignant skin lesion with margins measuring 3.1 to 4.0 cm in diameter. The procedure includes removal of the lesion and surrounding tissue to achieve appropriate oncologic margins.
Service type: Surgical excision of malignant lesion
Typical site of service: Skin of the scalp, neck, hands, feet, or genitalia (sex organs)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to a dermatologic surgery clinic with a biopsy-proven invasive squamous cell carcinoma on the dorsal hand measuring 3.4 cm in greatest diameter. The lesion is located on the hand, within the anatomical sites specified for this code. Preoperative evaluation includes history and focused physical exam, review of pathology confirming malignancy, marking margins, photographic documentation, and consent. On the day of service the patient undergoes excision under local or regional anesthesia in an ambulatory surgery setting. The surgeon measures the lesion and documents the post-excision specimen size and margins, performs hemostasis, and closes the defect with a primary closure. Operative notes document lesion diameter (3.4 cm), margin status, anesthesia, estimated blood loss, and whether additional procedures (e.g., flap or graft) were performed. Postoperative instructions and wound care are provided, and pathology of the excised specimen is sent for final margin evaluation. Billing uses 11624 for excision of a malignant lesion, including margins, 3.1–4.0 cm, from the skin of the hand, with appropriate modifiers added for circumstances such as multiple procedures, professional component, laterality, or unusual services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When identical procedure performed on both hands or paired sites in same session |
51 | Multiple procedures | When 11624 is billed with additional distinct CPT procedures on same day |
52 | Reduced services | If the excision is intentionally partially reduced or incomplete |
53 | Discontinued procedure | If procedure started but terminated for reasons unrelated to patient status |
59 | Distinct procedural service | To indicate a separate, distinct excision or unrelated procedure at a separate site |
62 | Two surgeons | When two surgeons work together as primary surgeons on the same excision |
76 | Repeat procedure by same physician | If the same physician repeats the excision during the postoperative period |
78 | Unplanned return to OR by same physician following initial procedure for a related procedure during the global period | For complications requiring return to the operating room related to the excision |
79 | Unrelated procedure or service by same physician during the postoperative period | For treatment of an unrelated condition during the global period |
LT | Left side | To indicate the procedure was performed on the left hand |
RT | Right side | To indicate the procedure was performed on the right hand |
22 | Unusual procedural services | When work required is substantially greater than typical for 11624 |
26 | Professional component | If reporting only the professional component of a service (rare for excision) |
TC | Technical component | If reporting only the technical component (rare for excision) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Dermatology | Most common specialty performing skin cancer excisions |
| 208800000X | General Surgery | Performs excisions for cutaneous malignancies, especially on complex sites |
| 2080P0004X | Plastic Surgery | Frequently performs excision with complex closure, grafts, or flaps |
| 207L00000X | Dermatopathology | Provides pathology interpretation for excised specimens |
| 2086S0127X | Hand Surgery (Surgery Subspecialty) | Used when excisions on the hand require specialized hand surgeon involvement |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.322 | Squamous cell carcinoma of skin of right hand | Common malignant diagnosis treated by 11624 when lesion is on the hand |
C44.321 | Squamous cell carcinoma of skin of left hand | As above for left-sided lesions |
C44.51 | Malignant neoplasm of skin of scalp and neck | Relevant when 11624 is used for scalp or neck lesions of specified size range |
C44.299 | Malignant neoplasm of skin of unspecified parts of face | Relevant for malignant skin lesions in anatomically similar areas included in excision coding |
D04.9 | Carcinoma in situ of skin, unspecified | May be an indication for excision if in situ lesion falls within size and site criteria |
C44.60 | Unspecified malignant neoplasm of skin of trunk, unspecified site | Provides context for malignant skin lesions that may require excision but are outside specified anatomic sites |
C44.311 | Basal cell carcinoma of skin of right hand | Basal cell carcinomas on the hand may be treated with excision coded with 11624 when malignant and size criteria met |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11102 | Tangential biopsy of skin (e.g., shave), single lesion | May be performed initially to obtain diagnostic tissue before definitive excision with 11624 |
11402 | Excision, benign lesion, skin of trunk, arms or legs; excised diameter 2.1 to 3.0 cm | Represents benign lesion excision codes used when pathology is non-malignant; contrasts with 11624 which is malignant |
12032 | Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm | May be reported when complex layered closure is performed following excision if coding rules allow separate reporting |
14060 | Adjacent tissue transfer or rearrangement, trunk, arms, legs; defect 30.1 sq cm to 60.0 sq cm | Used when a flap or complex reconstruction is required after excision of a large malignant lesion |
88305 | Surgical pathology, gross and microscopic examination | Used for histopathologic examination of the excised malignant specimen |
17000 | Destruction (e.g., laser) premalignant lesions (first lesion) | Alternative treatment modality for superficial premalignant lesions; may be part of treatment planning alongside excision |