2025 CPT code 11604

Excision of a malignant lesion, including margins, from the trunk, arms, or legs, with an excised diameter of 3.1 to 4.0 cm.

This code is for the excision of malignant lesions and includes local anesthesia and simple closure.Complex closure or reconstruction should be reported separately.Each separate malignant lesion excised requires a separate code. Modifier 58 is used if re-excision at the same site is performed during the postoperative period.

Modifiers may be applicable. For example, modifier 22 may be used for increased procedural services, and modifier 59 may be used for distinct procedural service. Review current CPT guidelines for modifier usage as per specific scenario.

Medical necessity for this procedure is established by the presence of a malignant skin lesion requiring surgical excision. Documentation should clearly support the diagnosis and the need for the specific procedure performed.

In simple words: Removal of skin cancer on the body (excluding face, hands, feet, neck, scalp, genitalia) measuring 3.1 to 4.0 cm across, including a safety margin of healthy skin.The area is then stitched closed.

This code describes the surgical removal of a malignant skin lesion, including margins, located on the trunk, arms, or legs. The excised diameter, which includes the lesion and the necessary margin of healthy tissue, measures between 3.1 and 4.0 cm. The procedure involves full-thickness removal through the dermis and includes simple closure.

Example 1: A patient presents with a 3.5 cm basal cell carcinoma on their arm. The physician excises the lesion with appropriate margins, totaling an excised diameter of 3.8 cm, and closes the wound with simple sutures. CPT code 11604 is reported., A patient has a 2.8 cm squamous cell carcinoma on their back. Due to its aggressive nature, the physician removes the lesion with wider margins, and the final excised diameter is 3.2 cm. Simple closure is performed. CPT code 11604 is reported., A patient has a 4.1 cm melanoma on their leg. Due to the size, an adjacent tissue transfer is performed. The appropriate code for adjacent tissue transfer is reported.

Documentation should include the location and size of the lesion, the diagnosis (type of malignancy), the size of the margins taken, the method of closure, and any complications encountered. Pathology reports confirming the diagnosis are essential.

  • Specialties:Dermatology, Plastic Surgery, General Surgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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