CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

Medicare pays $409 on average nationally for this procedure.

CPT code 21011 describes surgical excision of a small soft tissue tumor (less than 2 cm) located on the face or scalp in the subcutaneous plane; this represents a minor soft tissue tumor excision procedure typically performed by a surgeon or surgical specialist as an outpatient operative service in an ambulatory surgery center or hospital outpatient setting.

For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, Cochlear Implants, Balloon Dilation of the Eustachian Tube.

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CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

Medicare pays $409 on average nationally for this procedure.

For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, Cochlear Implants, Balloon Dilation of the Eustachian Tube.

Customize your policy alerts

Sign up for cpt 21011 policy alerts

Get alerted when payer policies referencing 21011 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient presents to the outpatient dermatologic clinic with a small, mobile subcutaneous lesion on the right forehead that has slowly enlarged over several months and occasionally bleeds when irritated. The lesion measures 1.2 cm by clinical exam and is presumed to be a benign soft tissue tumor (eg, epidermal inclusion cyst or lipoma). After discussion of risks, benefits, and alternatives, the dermatologist schedules an excision of the lesion under local anesthesia in the procedure room. The patient arrives on the day of service; standard pre-procedure vital signs and consent are completed. The provider infiltrates local anesthetic, makes a small incision directly over the lesion, dissections down to the subcutaneous plane, and removes the lesion intact. Hemostasis is achieved, and the wound is closed with subcutaneous and cutaneous sutures. Specimen is labeled and sent for pathologic evaluation. Post-procedure instructions and wound care are provided, with a routine follow-up visit arranged for suture removal. Typical site of service: outpatient dermatology or ambulatory surgery clinic. Service type: minor soft tissue tumor excision of the face/scalp under skin, less than 2 cm, corresponding to a minor surgical procedure performed under local anesthesia.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm	May be used if closure requires intermediate layered repair after lesion excision when wound length falls within size range.
`11400`	Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms, legs; excised diameter 0.5 cm or less	Alternative excision codes for benign skin lesions on trunk/limbs — not typically used for face/scalp but relevant for similar procedures on other sites.
`88305`	Level IV surgical pathology, gross and microscopic examination	Used when the excised specimen is sent to pathology for histologic evaluation.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common same-day E/M code when a separate evaluation and management service is documented alongside the procedure.
`12011`	Repair, intermediate, wounds of forehead, cheeks, chin, mouth, neck; 2.6 cm to 7.5 cm	Related repair code if intermediate closure of facial wound is required following excision.

Related Modifiers

5 rows

Modifier	Description	When to Use
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
[object Object]
1P	Modifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure…	- Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically…
[object Object]

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
1835P1200X	Pharmacotherapy Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implemen…
246XS1301X	Sonography Specialist/Technologist Cardiovascular	A cardiovascular sonography technologist operates special equipment to create images and conduct tests of the cardiovascular system. They work with ph…
1223P0106X	Oral and Maxillofacial Pathology Dentistry	The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and m…
364SR0400X	Rehabilitation Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
251V00000X	Voluntary or Charitable Agency	Agencies · Voluntary or Charitable
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
213EG0000X	Deactivated - Podiatrist

Related Payer Policy Updates

Specialty: Otorhinolaryngology (ENT)1 / 2

10 rows

Policy	Payer	Effective Date
Oral Cancer Screening and Testing	Oscar Health	2026-10-01
Cochlear Implants	Blue Cross Blue Shield - Rhode Island	2026-09-01
Balloon Dilation of the Eustachian Tube	Blue Cross Blue Shield - Rhode Island	2026-09-01
Sinus Surgeries and Interventions (for New Mexico Only)	UnitedHealthcare	2026-08-01
Surgical Treatment of Snoring and Obstructive Sleep	Premera Bluecross	2026-08-01
Hearing Aids and Auditory Implants	UnitedHealthcare	2026-08-01
Sinus Surgeries and Interventions (for Tennessee Only)	UnitedHealthcare	2026-08-01
Repair of Nasal Valve Compromise	Ambetter Georgia	2026-08-01
Surgical Treatment of Snoring and Obstructive Sleep (OSA)	Premera Bluecross	2026-08-01
Sinus Surgeries and Interventions (for Kentucky Only)	UnitedHealthcare	2026-08-01

CPT 21012: Excision of Soft Tissue Tumor, Face or Scalp

CPT-21013-SOFT-TISSUE-TUMOR-EXCISION-FACE-SCALP

CPT 21013: Excision of Soft Tissue Tumor, Face or Scalp

CPT-21014-SOFT-TISSUE-TUMOR-EXCISION-FACE-SCALP

CPT 21014: Excision of Soft Tissue Tumor of Face or Scalp

CPT-21015-RADICAL-EXCISION-FACE-SCALP-TUMOR

CPT 21015: Radical Excision of Tumor from Face or Scalp

CPT-21016-EXTENSIVE-EXCISION-SOFT-TISSUE-TUMOR-FACE-SCALP

CPT 21016: Excision of Soft Tissue Malignant Tumor, Face/Scalp, ≥2 cm

CPT-21025-MANDIBULAR-OSTEOMYELITIS-DEBRIDEMENT

CPT 21025: Debridement for Mandibular Osteomyelitis

CPT-21026-FACIAL-BONE-OSTEOMYELITIS-EXCISION

CPT 21026: Excision/Debridement of Infected Facial Bone

CPT-21029-BONE-TUMOR-CONTOURING-RESHAPING

CPT 21029: Removal of Benign Bone Lesion by Contouring

CPT-21030-ENUCLEATION-CURETTAGE-BENIGN-MAXILLARY-ZYGOMA-TUMOR

CPT 21030: Enucleation/Curettage of Upper Jaw and Cheekbone

CPT-21031-MANDIBULAR-TORUS-EXCISION

CPT 21031: Excision of Torus Mandibularis

Showing 1–10 of 22

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm	May be used if closure requires intermediate layered repair after lesion excision when wound length falls within size range.
`11400`	Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms, legs; excised diameter 0.5 cm or less	Alternative excision codes for benign skin lesions on trunk/limbs — not typically used for face/scalp but relevant for similar procedures on other sites.
`88305`	Level IV surgical pathology, gross and microscopic examination	Used when the excised specimen is sent to pathology for histologic evaluation.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common same-day E/M code when a separate evaluation and management service is documented alongside the procedure.
`12011`	Repair, intermediate, wounds of forehead, cheeks, chin, mouth, neck; 2.6 cm to 7.5 cm	Related repair code if intermediate closure of facial wound is required following excision.

Related Modifiers

5 rows

Modifier	Description	When to Use
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
[object Object]
1P	Modifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure…	- Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically…
[object Object]

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
1835P1200X	Pharmacotherapy Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implemen…
246XS1301X	Sonography Specialist/Technologist Cardiovascular	A cardiovascular sonography technologist operates special equipment to create images and conduct tests of the cardiovascular system. They work with ph…
1223P0106X	Oral and Maxillofacial Pathology Dentistry	The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and m…
364SR0400X	Rehabilitation Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
251V00000X	Voluntary or Charitable Agency	Agencies · Voluntary or Charitable
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
213EG0000X	Deactivated - Podiatrist

Related Payer Policy Updates

Specialty: Otorhinolaryngology (ENT)1 / 2

10 rows

Policy	Payer	Effective Date
Oral Cancer Screening and Testing	Oscar Health	2026-10-01
Cochlear Implants	Blue Cross Blue Shield - Rhode Island	2026-09-01
Balloon Dilation of the Eustachian Tube	Blue Cross Blue Shield - Rhode Island	2026-09-01
Sinus Surgeries and Interventions (for New Mexico Only)	UnitedHealthcare	2026-08-01
Surgical Treatment of Snoring and Obstructive Sleep	Premera Bluecross	2026-08-01
Hearing Aids and Auditory Implants	UnitedHealthcare	2026-08-01
Sinus Surgeries and Interventions (for Tennessee Only)	UnitedHealthcare	2026-08-01
Repair of Nasal Valve Compromise	Ambetter Georgia	2026-08-01
Surgical Treatment of Snoring and Obstructive Sleep (OSA)	Premera Bluecross	2026-08-01
Sinus Surgeries and Interventions (for Kentucky Only)	UnitedHealthcare	2026-08-01

CPT 21012: Excision of Soft Tissue Tumor, Face or Scalp

CPT-21013-SOFT-TISSUE-TUMOR-EXCISION-FACE-SCALP

CPT 21013: Excision of Soft Tissue Tumor, Face or Scalp

CPT-21014-SOFT-TISSUE-TUMOR-EXCISION-FACE-SCALP

CPT 21014: Excision of Soft Tissue Tumor of Face or Scalp

CPT-21015-RADICAL-EXCISION-FACE-SCALP-TUMOR

CPT 21015: Radical Excision of Tumor from Face or Scalp

CPT-21016-EXTENSIVE-EXCISION-SOFT-TISSUE-TUMOR-FACE-SCALP

CPT 21016: Excision of Soft Tissue Malignant Tumor, Face/Scalp, ≥2 cm

CPT-21025-MANDIBULAR-OSTEOMYELITIS-DEBRIDEMENT

CPT 21025: Debridement for Mandibular Osteomyelitis

CPT-21026-FACIAL-BONE-OSTEOMYELITIS-EXCISION

CPT 21026: Excision/Debridement of Infected Facial Bone

CPT-21029-BONE-TUMOR-CONTOURING-RESHAPING

CPT 21029: Removal of Benign Bone Lesion by Contouring

CPT-21030-ENUCLEATION-CURETTAGE-BENIGN-MAXILLARY-ZYGOMA-TUMOR

CPT 21030: Enucleation/Curettage of Upper Jaw and Cheekbone

CPT-21031-MANDIBULAR-TORUS-EXCISION

CPT 21031: Excision of Torus Mandibularis

Showing 1–10 of 22

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

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OpenPayer

CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

Sign up for cpt 21011 policy alerts

CPT 21011: Excision of Small Subcutaneous Soft Tissue Tumor, Face/Scalp

Sign up for cpt 21011 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What procedure does CPT 21011 describe and where is it typically performed?

Should the excised lesion be sent to pathology and which related code is listed?

Are there related CPT codes that might be reported with or instead of 21011?

What diagnosis codes are commonly associated with CPT 21011?

What documentation details are important to support coding CPT 21011?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What procedure does CPT 21011 describe and where is it typically performed?

Should the excised lesion be sent to pathology and which related code is listed?

Are there related CPT codes that might be reported with or instead of 21011?

What diagnosis codes are commonly associated with CPT 21011?

What documentation details are important to support coding CPT 21011?

References