Summary & Overview
CPT 11606: Excision of Malignant Skin Lesion, Over 4.0 cm, Trunk/Arms/Legs
CPT code 11606 represents the excision of a malignant skin lesion, including margins, from the trunk, arms, or legs, with an excised diameter greater than 4.0 cm. This procedure is a critical component of dermatologic and surgical care for patients with large malignant lesions, such as melanoma, and is commonly performed by specialists in dermatology and surgery. Nationally, this code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage for patients undergoing this procedure.
This publication provides a comprehensive overview of CPT 11606, including payer coverage, clinical context, and related billing considerations. Readers will gain insight into the clinical indications for the code, typical use cases, and associated diagnoses such as malignant melanoma of various skin sites. The summary also highlights relevant modifiers and taxonomies, offering clarity on how this code fits within broader billing and policy frameworks. Key benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements for accurate reporting and reimbursement. The information is organized to support healthcare professionals, billing specialists, and policy analysts in understanding the national landscape for this high-complexity skin excision procedure.
CPT Code Overview
CPT 11606 is used to report the excision of a malignant skin lesion, including margins, from the trunk, arms, or legs, where the excised diameter is over 4.0 cm. This code falls under surgical procedures on the skin (Integumentary Surgery). The typical site of service for this procedure is not specified in the available data. This code is significant for clinicians and billing professionals managing cases involving large malignant skin lesions requiring surgical removal.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a dermatology or surgical clinic with a suspicious skin lesion on the trunk, arms, or legs. The lesion is clinically diagnosed as malignant, such as malignant melanoma, and measures over 4.0 cm in excised diameter. The provider performs a surgical excision of the lesion, including appropriate margins, to ensure complete removal. The procedure is commonly performed by dermatologists, MOHS surgeons, or general surgeons, and may occur in an outpatient surgical suite or ambulatory setting. Postoperative care includes wound management and pathology review to confirm clear margins.
Coding Specifications
-
Modifier
59: Distinct Procedural Service. Used when a procedure or service is distinct or independent from other services performed on the same day. -
Modifier
51: Multiple Procedures. Used when multiple procedures are performed during the same session by the same provider.
| Modifier Code | Description |
|---|---|
59 | Distinct Procedural Service |
51 | Multiple Procedures |
Associated Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207N00000X | Dermatology |
207ND0101X | MOHS-Micrographic Surgery |
208600000X | Surgery |
207N00000X: Dermatologists specializing in skin conditions and procedures.207ND0101X: MOHS surgeons specializing in micrographic surgery for skin cancer.208600000X: General surgeons performing a variety of surgical procedures, including skin excisions.
Related Diagnoses
-
C43.51: Malignant melanoma of anal skin- Relevant for excision of malignant lesions located on the anal skin, which may require wide excision as described by
11606.
- Relevant for excision of malignant lesions located on the anal skin, which may require wide excision as described by
-
C43.52: Malignant melanoma of skin of breast- Indicates malignant melanoma on the breast skin, which may be excised using the procedure described by
11606if the lesion is on the trunk.
- Indicates malignant melanoma on the breast skin, which may be excised using the procedure described by
-
C43.59: Malignant melanoma of other part of trunk- Applies to malignant melanoma on any other part of the trunk, directly relevant to the excision procedure.
-
C43.60: Malignant melanoma of unspecified upper limb, including shoulder- Used for malignant melanoma on the upper limb or shoulder, which falls within the anatomical scope of
11606.
- Used for malignant melanoma on the upper limb or shoulder, which falls within the anatomical scope of
Related CPT Codes
| CPT Code | Description | Clinical Relationship to 11606 |
|---|---|---|
10060 | Data not available in the input. | May be used for incision and drainage procedures, not directly related to excision of malignant lesions. |
10061 | Data not available in the input. | Similar to 10060, for more complex drainage. |
11200 | Data not available in the input. | Used for removal of skin tags, not malignant lesions. |
11201 | Data not available in the input. | Additional skin tag removal. |
17260 | Data not available in the input. | Excision of malignant lesions, may be used as an alternative or for different anatomical sites. |
17261 | Data not available in the input. | Similar to 17260, for different lesion sizes or sites. |
17262 | Data not available in the input. | As above. |
17263 | Data not available in the input. | As above. |
17264 | Data not available in the input. | As above. |
17266 | Data not available in the input. | As above. |
17270 | Data not available in the input. | As above. |
17271 | Data not available in the input. | As above. |
17272 | Data not available in the input. | As above. |
17273 | Data not available in the input. | As above. |
17274 | Data not available in the input. | As above. |
17276 | Data not available in the input. | As above. |
17280 | Data not available in the input. | As above. |
17281 | Data not available in the input. | As above. |
17282 | Data not available in the input. | As above. |
17283 | Data not available in the input. | As above. |
17284 | Data not available in the input. | As above. |
Codes in the 17260-17284 range are commonly used for excision of malignant skin lesions and may be alternatives or used for different anatomical sites or lesion sizes. Codes 10060, 10061, 11200, and 11201 are less commonly used in conjunction with 11606 but may be performed in the same session for other skin conditions.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 11606 under Medicare is $477.15, while the BUCA (average commercial) mean rate is $478.32. This indicates that Medicare and commercial payers are closely aligned in their average reimbursement for this procedure.
Rate dispersion varies significantly across payers. UnitedHealth Group exhibits the widest spread, with a difference of $415.33 between the 75th and 25th percentiles. In contrast, Medicare shows the tightest range, with only $47.00 separating its 75th and 25th percentiles, reflecting more consistent rates. Cigna and Blue Cross Blue Shield also display substantial dispersion, suggesting greater variability in commercial reimbursement.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
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.