CPT 12012: Excision of Skin Lesion, 1.1–2.0 cm, Simple Repair - OpenPayer

Summary & Overview

CPT 12012: Excision of Skin Lesion, 1.1–2.0 cm, Simple Repair

CPT code 12012 denotes the excision of a skin lesion with simple repair for lesions measuring 1.1 to 2.0 cm. This minor dermatologic surgical code is commonly used in outpatient settings — including dermatology offices and ambulatory surgical centers — for removal of benign or malignant cutaneous lesions followed by primary closure. Nationally, use of this code matters because it captures a frequent outpatient surgical service that affects surgical case mix, outpatient procedural volumes, and payer cost and utilization patterns.

Key payers included in the coverage for this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and expected documentation elements for coding accuracy. The publication also provides benchmarking and reimbursement context when available, relevant policy updates affecting outpatient dermatologic procedures, and connections to related procedural codes where clinicians and billing staff commonly need guidance.

This summary is intended for national audiences involved in clinical coding, revenue cycle management, and outpatient surgical care to support accurate code assignment, claims preparation, and awareness of payer coverage considerations.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 12012dermatologic surgeryskin lesion excisionminor surgical proceduresoutpatient surgeryprocedural codingsimple repairmedical billingsurgical pathology

Billing Code Overview

CPT code 12012 represents the excision of a skin lesion with simple repair for a lesion measuring 1.1 to 2.0 cm. The service type is a minor dermatologic surgical procedure involving lesion removal and primary closure. The typical site of service is an outpatient procedure setting such as a dermatologist's office, ambulatory surgery center, or outpatient clinic.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who presents to a dermatology clinic or ambulatory surgical center with a benign or malignant skin lesion on the torso, extremity, or head/neck requiring excision and simple repair. After clinical evaluation and local anesthesia, the clinician performs lesion excision with simple closure, often for lesions between 1.1 cm and 2.0 cm in diameter of the excised tissue. The workflow includes pre-procedure consent, marking margins, administration of local anesthetic (eg, lidocaine with epinephrine), removal of the lesion with appropriate margins, hemostasis, layered simple closure with sutures, and post-procedure wound care instructions. Specimens are often sent for pathology when clinically indicated. Typical sites of service are outpatient dermatology offices, ambulatory surgery centers, and primary care procedure rooms.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of procedure	Use when a distinct E/M service is documented in addition to the procedure on the same day.
`59`	Distinct procedural service	Use when a different anatomic site or distinct procedural service is performed the same day.

CPT 12020: Simple Closure for Wound Dehiscence

cpt-12011-simple-repair-superficial-facial-wound-2-5cm-or-less

CPT 12011: Simple Repair of Superficial Facial and Mucous Membrane Wounds

12006

CPT 12006: Simple Repair of Superficial Wounds, 20.1–30.0 cm

cpt-12019-minor-soft-tissue-repair-wound-repair

CPT 12019: Minor Soft Tissue/Wound Repair Procedure

cpt-32100-thoracotomy-exploratory-chest-surgery

CPT 32100: Thoracotomy for Exploratory Examination of Chest

12015

CPT 12015: Simple Repair of Superficial Facial Wounds

12010

CPT 12010: Simple Repair of Superficial Facial Wounds, 2.5 cm or Less

cpt-12006-simple-repair-superficial-wounds-20-1-30-cm

CPT 12006: Simple Repair of Superficial Wounds, 20.1–30.0 cm

12021

CPT 12021: Intermediate Wound Repair, 2.6–7.5 cm

cpt-62270-diagnostic-spinal-puncture-csf-sampling

CPT 62270: Diagnostic Spinal Puncture for Cerebrospinal Fluid Sampling

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Taxonomy Code	Specialty	Notes
207P00000X	Dermatology	Dermatologists commonly perform skin lesion excisions and simple repairs.
207Q00000X	General Surgery	General surgeons perform excisions for larger or deeper skin lesions and malignancies.
208000000X	Family Medicine	Primary care physicians with procedural training perform excisions in office settings.
207L00000X	Plastic Surgery	Plastic surgeons perform excisions with emphasis on cosmetic outcomes and complex closures.
207R00000X	Otolaryngology	ENT surgeons perform excisions in head and neck locations requiring specialized anatomic knowledge.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L57.0`	Actinic keratosis	Frequently excised or treated lesions when suspicious or symptomatic.
`D23.9`	Nevus, benign, unspecified	Common benign pigmented lesions that may be excised for diagnosis or cosmetic reasons.
`L82.1`	Seborrheic keratosis	Benign epidermal lesions often removed for symptomatic or cosmetic concerns.
`C44.91`	Basal cell carcinoma of skin, unspecified site	Common skin cancer requiring complete excision with simple closure when small.
`C44.92`	Squamous cell carcinoma of skin, unspecified site	Malignant lesion that may be excised with margin control and pathology.
`R22.9`	Localized swelling, mass and lump of skin and subcutaneous tissue	Presentation leading to excision for diagnosis.
`L98.9`	Disorder of skin and subcutaneous tissue, unspecified	General symptom code used when precise diagnosis is pending after excision.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12002`	Repair, simple, wound(s), scalp, arms, and/or legs; 0.6 cm to 2.5 cm	Alternative simple repair code for smaller or multiple small wounds; used if repair dimensions differ.
`11102`	Tangential biopsy of skin (eg, shave); single lesion	Performed when a diagnostic shave biopsy is obtained instead of full excision prior to definitive management.
`11107`	Tangential biopsy of skin, trunk, arms, legs; each additional lesion	Used when multiple shave biopsies are performed in the same encounter.
`11402`	Excision, benign lesion including margins, trunk, arms, or legs; 1.1 cm to 2.0 cm	Similar excision code for benign lesions; chosen based on lesion type and coding guidance.
`88305`	Level IV - Surgical pathology, gross and microscopic examination	Pathology examination commonly performed on excised tissue to establish diagnosis and margin status.

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