Summary & Overview
CPT 11644: Excision of Malignant Skin Lesion, 3.1–4.0 cm, Face/Eyelids/Nose/Lips
CPT code 11644 represents the surgical excision of a malignant skin lesion, including margins, measuring 3.1 to 4.0 cm located on high-risk anatomic sites of the head and neck such as the face, ears, eyelids, nose, and lips. This code is important nationally because it governs coding, billing, and coverage for oncologic skin surgeries in cosmetically and functionally sensitive areas where margin control and reconstruction considerations influence care pathways and cost. Major payers relevant to national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing context for CPT code 11644, including typical sites of service, the clinical scenarios that map to this code, and the payer landscape covered in the review. The publication outlines benchmarks and payment context, common modifier use and coding nuances, and implications for surgical planning and documentation. It also highlights clinical considerations tied to lesion size and location that affect coding choice. Data not provided in the input—such as specific ICD-10 pairings, taxonomies, and payer-specific reimbursement rates—are noted as unavailable where applicable.
Billing Code Overview
CPT code 11644 describes the surgical excision of a malignant skin lesion with margins, measuring 3.1 to 4.0 cm in diameter, from anatomically sensitive areas including the face, ears, eyelids, nose, and lips. The procedure involves removal of the lesion and surrounding tissue to achieve appropriate oncologic margins.
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Service type: Surgical excision (oncologic skin surgery)
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Typical site of service: Ambulatory surgical center or hospital outpatient department; procedure is performed on the head and neck region (face, ears, eyelids, nose, lips).
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a dermatology clinic with a biopsy-confirmed malignant cutaneous lesion located on the nasal ala measuring 3.5 cm in greatest diameter. The lesion is suspicious for invasive cutaneous squamous cell carcinoma. After preoperative evaluation, the patient is consented for surgical excision under local anesthesia with possible sedation. The clinical workflow includes preoperative photography and marking of margins, local anesthetic infiltration, elliptical excision of the lesion including appropriate peripheral and deep margins to achieve oncologic control, hemostasis, specimen labeling and orientation for pathology, and layered wound closure with possible local flap or graft if primary closure is not feasible. Specimen is submitted to pathology with size and margin annotations. Postoperative instructions and wound-care plan are provided; follow-up is arranged for suture removal and pathology review. Typical site of service is an outpatient dermatology or ambulatory surgical center; providers commonly include dermatologic surgeons, plastic surgeons, and otolaryngologists.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service on the same day as a procedure | Use when a distinct E/M visit occurs prior to the excision (Note: 25 was not in provided list; see STRICT RULES — Data not available in the input.) |