2025 CPT code 11104
(Active) Effective Date: N/A Surgery - Integumentary System Feed
Punch biopsy of skin (including simple closure, when performed); single lesion.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), or reduced services (52).
Medical necessity must be established by documenting the clinical indication for the biopsy (e.g., suspicious lesion, persistent rash, unclear diagnosis).
The physician prepares the patient, administers local anesthesia, selects the appropriate punch size, performs the biopsy, and may close the wound with sutures. The specimen is sent to pathology for analysis.
In simple words: A small, circular piece of skin is removed using a special tool for examination under a microscope.The doctor may stitch the area closed if needed.
This code represents a punch biopsy procedure performed on a single skin lesion, including simple closure if performed. A punch biopsy involves using a circular tool to remove a cylindrical full-thickness sample of skin for diagnostic purposes.
Example 1: A patient presents with a suspicious mole on their back. A punch biopsy is performed to determine if it is cancerous., A dermatologist performs a punch biopsy of a persistent rash to aid in diagnosis., A patient with a cyst has a punch biopsy to determine its nature and guide treatment.
Document lesion location and size, punch size used, method of closure (if any), and any complications.
- RVU: 0.83 (non-facility), 3.52 (facility)
- Global Days: Included in procedure
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Dermatology, Family Medicine, General Surgery, Plastic Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center