CPT Code Overview

CPT 11602 describes the excision of a malignant skin lesion with margins on the trunk, arms, or legs for a lesion measuring 1.1–2.0 cm. This is a surgical procedure focused on removal of malignant cutaneous lesions and includes excision down to the necessary depth to achieve margins appropriate for a malignant diagnosis.

Service type: Surgical procedure – skin (excision of malignant lesion)

Typical site of service: Dermatology or surgical office (e.g., Office – POS 11)

Clinical Context

A middle-aged or older adult presents to a dermatology clinic with a pigmented or suspicious cutaneous lesion on the trunk or an extremity. Examination and dermoscopy raise concern for a malignant lesion (for example, malignant melanoma at sites such as the trunk or upper limb). The clinician documents lesion size after complete evaluation; for a lesion measured between 1.1 and 2.0 cm in greatest diameter, the procedure performed is a surgical excision with margins. The typical workflow: pre-procedure consent and marking, local anesthesia, elliptical excision of the lesion including prescribed margins, layered closure, specimen labeled and sent to pathology, and post-procedure wound care instructions. Usual site of service is a dermatology or surgical office (Office – POS 11).

Coding Specifications

• Modifier 59 – Distinct Procedural Service

• Use when an excision procedure is separate and distinct from other procedures performed on the same date (for example, when two unrelated lesions are excised in different anatomic sites and documentation supports distinct procedural services).

• Modifier 51 – Multiple Procedures

• Use when multiple procedures are performed at the same session on the same patient by the same provider and payer rules require identification of multiple procedures (report primary procedure and append 51 to secondary procedures as required by payer).

Provider Taxonomies

• 207N00000X (Dermatology): Represents general dermatologists who perform diagnostic evaluation and surgical excisions of skin malignancies.

• 207ND0101X (MOHS-Micrographic Surgery): Represents surgeons specialized in microscopically controlled excision techniques; related when definitive margin control is needed.

• 207NS0135X (Procedural Dermatology): Represents dermatologists focused on surgical and procedural management of skin disease, including excisions and closures.

Related Diagnoses

• C43.51 — Malignant melanoma of anal skin

• Clinical relevance: A malignant melanoma located on the anal skin is a primary skin malignancy that may require surgical management; if the lesion on the trunk or proximal perianal area measures 1.1–2.0 cm, 11602 could apply when excision with margins is performed.

• C43.52 — Malignant melanoma of skin of breast

• Clinical relevance: Melanoma arising on the skin of the breast may be treated with wide local excision; lesion size within 1.1–2.0 cm is consistent with reporting 11602 when surgical excision including margins is performed.

• C43.59 — Malignant melanoma of other part of trunk

• Clinical relevance: Melanoma of the trunk is a common indication for surgical excision; lesions measuring 1.1–2.0 cm fit the size descriptor for 11602.

• C43.60 — Malignant melanoma of unspecified upper limb, including shoulder

• Clinical relevance: Melanoma on an upper limb or shoulder may be managed with excision; when the malignant lesion measures 1.1–2.0 cm on the arm, 11602 is the appropriate excision code.

Related CPT Codes

• Clinical relationships to 11602:

• 11200 and 11201 may be billed when periprocedural injections or catheter introductions are separately reported; these are ancillary to the excision when individually reportable.

• 17000 is for destruction of premalignant lesions and is an alternative service for noninvasive lesions rather than excision of a confirmed malignant lesion.

• The 1726x, 1727x, and 1728x series are codes for destruction of malignant lesions by destructive modalities (e.g., cryotherapy, electrosurgery). These codes are alternatives to surgical excision (11602) when destruction rather than excision is the chosen method or when insurer policy allows destruction for specific malignant lesions.

• Codes with lesion diameters matching 1.1–2.0 cm (for example 17262, 17272, 17282) represent size-correlated destructive procedures that may be considered alternatives to an excision coded with 11602 depending on clinical approach.

• Multiple procedures performed at the same visit (for example excision plus destruction of other lesions) may require reporting of both codes with appropriate modifiers such as 51 or 59 as payer policy dictates.

Across national benchmarks, Medicare mean allowed rates ($249.09) are slightly below the aggregated commercial BUCA mean ($260.31) for 11602, with a difference of $11.22. UnitedHealth Group and Cigna report the highest commercial mean rates, while Aetna reports the lowest mean among the listed national payers.

Rate dispersion (P75 minus P25) varies by payer: Cigna shows the widest interquartile spread (407.00 - 212.00 = $195.00), followed by UnitedHealth Group (444.33 - 224.50 = $219.83) and BUCA (312.00 - 176.67 = $135.33). Medicare has the tightest range (259.00 - 232.00 = $27.00), indicating the least dispersion among reported payers. The table and chart below present the full percentile and mean-rate breakdown.