2025 CPT code 11620
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision of Malignant Lesions Integumentary System Feed
Excision of malignant skin lesion with margins; excised diameter 0.5 cm or less.
Modifiers 58 and 59 may be applicable, as described above.
Excision is medically necessary for the diagnosis and treatment of malignant skin lesions. The removal of the lesion and surrounding margins is crucial for preventing recurrence and metastasis.
The clinical responsibility includes pre-operative assessment, lesion marking, full-thickness excision, hemostasis, wound closure, and pathology specimen preparation.
- Integumentary System
- Surgical Procedures on the Skin, Subcutaneous and Accessory Structures; Excision-Malignant Lesions Procedures on the Skin
In simple words: This code covers the surgical removal of a cancerous skin growth that's 0.5 centimeters or smaller, including a small area of healthy skin around it. The doctor cuts out the growth and stitches the skin closed. If more stitches are needed or there are other repairs, there will be extra charges. If additional surgery is needed later due to the cancer not being fully removed, there will be other codes applied.
Surgical removal of a malignant skin lesion, including surrounding margins, with an excised diameter of 0.5 cm or less.The procedure involves full-thickness removal through the dermis, encompassing the lesion and the necessary margins for complete excision. Simple closure (non-layered) is included.The excised diameter is measured prior to the excision and includes the lesion plus margins.Separate codes are reported for each lesion excised.If more extensive closure (intermediate or complex) is required, additional codes (12031-12057, 13100-13153) are reported separately.For reconstructive closure, codes 15002-15261, 15570-15770 are used.If performed with adjacent tissue transfer, only the tissue transfer code (14000-14302) is reported.If margins are inadequate based on frozen section pathology, an additional excision at the same operative session is reported using this code based on the final excised diameter.A subsequent re-excision at a different session uses codes 11600-11646, with modifier 58 appended.
Example 1: A 65-year-old male presents with a suspicious lesion on his scalp measuring 0.4 cm in diameter.The lesion is excised, and pathology confirms basal cell carcinoma. Code 11620 is reported., A 72-year-old female with a 0.2 cm lesion on her nose undergoes excision. Frozen section analysis reveals positive margins.A second excision is performed at the same session, widening the margins. Code 11620 is reported once, reflecting the final excised diameter., A 48-year-old presents with two separate lesions on the back. One is 0.3cm and the other is 0.6cm. Code 11620 with modifier 59 would be used for the 0.3cm and code 11621 for the 0.6cm lesion.
Complete patient history, physical examination findings, lesion size measurements before and after excision, pathology report confirming malignancy, details of wound closure, and any post-operative notes.
** Accurate measurement of the lesion and margins is crucial for correct code selection.Pathology reports must verify the presence of malignancy for appropriate medical necessity.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: Refer to the CMS relative value units database for the most up-to-date information.RVUs vary based on geographic location and other factors.
- Global Days: The global period varies by payer but is typically 0 days.Consult payer guidelines for specific information.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedule data is not provided.Refer to historical fee schedules and databases.
- Specialties:Dermatology, Surgical Oncology, Plastic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital Outpatient Department