2025 CPT code 11404
Effective Date: N/A Surgery - Integumentary System Feed
Excision of benign lesion, including margins, except skin tag (unless listed elsewhere), trunk, arms, or legs; excised diameter 3.1 to 4.0 cm.
Modifiers may be applicable to indicate specific circumstances, such as multiple lesions or significant additional work. Refer to the latest CPT manual.
Medical necessity for excision of a benign lesion should be documented.The documentation must support that the lesion was causing symptoms (e.g., pain, bleeding, infection) impacting the patient's quality of life or presented a risk of future complications if left untreated.Alternatively, documentation could support removal due to diagnostic uncertainty necessitating pathological examination.
In simple words: Removal of a non-cancerous skin growth, not a skin tag, between 3.1 and 4.0 cm in size, from your trunk, arms, or legs. This includes numbing the area and stitching up the skin afterward.
Excision (including simple closure) of a benign lesion, other than a skin tag, on the trunk, arms, or legs, measuring 3.1 to 4.0 cm in diameter, including margins. This includes local anesthesia and simple (non-layered) closure.
Example 1: A patient presents with a benign cyst on their arm measuring 3.5 cm in diameter. The physician excises the cyst, including margins, and closes the wound with simple sutures., A patient has a 3.2 cm diameter lipoma on their back. The surgeon removes the lipoma and closes the defect with a simple closure., A patient has a 3.8 cm dermatofibroma on their leg. Following excision of the lesion, the physician performs a simple closure.
Documentation should include the size and location of the lesion, the diagnosis, the margins excised, the type of closure performed, and any complications encountered.
- Specialties:Dermatology, Plastic Surgery, General Surgery, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center