2025 CPT code 11640
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Excision of malignant skin lesion, including margins, on the face, ears, eyelids, nose, or lips; excised diameter 0.5 cm or less.
Modifiers 58 (staged or related procedure), 59 (distinct procedural service), and others may be applicable depending on the circumstances of the procedure.
Surgical excision is medically necessary for the removal of malignant skin lesions to prevent local tissue destruction and potential metastasis. The choice of excision versus other treatment modalities (e.g., destruction) depends on lesion characteristics and patient factors.
The clinical responsibility includes the appropriate preparation of the surgical site, administration of local anesthesia, precise excision of the lesion with appropriate margins, hemostasis (control of bleeding), wound closure, and appropriate documentation. Pathological assessment of the excised tissue is also a clinical responsibility.In cases of inadequate margins, a re-excision might be necessary, and frozen section analysis may be used intraoperatively.
In simple words: The doctor removes a cancerous growth from the face, ears, eyelids, nose, or lips.The growth and a small area around it are taken out, and the skin is stitched closed. This is done for cancerous growths smaller than 0.5 centimeters.
This CPT code encompasses the surgical excision of a malignant lesion (e.g., basal cell carcinoma, squamous cell carcinoma, melanoma) located on the face, ears, eyelids, nose, or lips. The procedure includes the complete removal of the lesion and surrounding margins, with simple closure of the resulting wound.The greatest clinical diameter of the lesion plus the narrowest margin required for complete excision determines code selection.The excised diameter remains the same regardless of the closure method (linear or reconstructive).
Example 1: A 65-year-old male presents with a 0.4 cm basal cell carcinoma on his left lower eyelid. The surgeon excises the lesion with a 2mm margin, achieving complete removal. Simple closure is performed., A 72-year-old female presents with a 0.3 cm squamous cell carcinoma on her right ear.A frozen section is taken during the procedure to ensure complete tumor removal.Simple wound closure is performed., An 80-year-old male has multiple small lesions (less than 0.5cm each) on his nose identified as basal cell carcinomas.Each is excised with a margin, and simple closure is performed on each. Modifier 59 may be used to indicate distinct procedural services for multiple lesions.
** Accurate measurement of the lesion and margins is critical for proper code selection.Consideration should be given to the need for frozen section analysis, particularly with high-risk lesions such as melanomas.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: This information is not included in the provided text and would require referencing a fee schedule or other payment guidelines.
- Global Days: The global surgical period is not specified in the provided information and would require referencing current guidelines.
- Payment Status: Active
- Modifier TC rule: The use of a technical component (TC) modifier is not directly applicable to this code, as it typically encompasses the entire procedure.
- Fee Schedule: Fee schedule data is not included in the provided text and would need to be obtained from relevant payer resources.
- Specialties:Dermatology, Plastic Surgery, Otolaryngology, General Surgery
- Place of Service:Office, Ambulatory Surgery Center, Hospital (Inpatient or Outpatient)