2025 CPT code 11646
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Excision of a malignant lesion, including margins, on the face, ears, eyelids, nose, or lips, with an excised diameter greater than 4.0 cm.
Modifiers may be applicable. Modifier 58 is used for staged or related procedures during the postoperative period. Modifier 59 is used to distinguish procedures performed on separate lesions.
Medical necessity is established by the diagnosis of a malignant skin lesion requiring excision.
The physician prepares the area, administers local anesthesia, marks the excision margins, makes a full-thickness incision, removes the lesion and margins, controls bleeding, closes the wound, and may send the excised tissue for pathological analysis.
In simple words: Removal of skin cancer larger than 4 cm from the face, ears, eyelids, nose, or lips. The procedure involves cutting out the cancerous growth and some surrounding healthy skin to ensure complete removal. The skin is then stitched back together.
Excision of a malignant skin lesion, including margins, from the face, ears, eyelids, nose, or lips. The excised diameter, which includes the lesion's greatest clinical diameter plus the required margin for complete excision, is over 4.0 cm. This procedure involves full-thickness removal through the dermis and includes simple closure.For eyelids involving more than skin, see also 67800 et seq.
Example 1: A patient presents with a 5.2 cm basal cell carcinoma on their right cheek. The physician excises the lesion with appropriate margins, resulting in a total excised diameter of 5.5 cm. Code 11646 is reported., A patient with a 4.5 cm squamous cell carcinoma on their nose undergoes excision.Due to the location and size, reconstruction is required.The excision is reported with 11646 and the complex repair is reported separately., A patient has a 6.0 cm melanoma on their left ear. After excision and simple closure, the pathology report shows positive margins. A re-excision is performed during the same operative session; the final excised diameter is 7 cm. Code 11646 is reported a single time based on the largest excised diameter.
Documentation should include lesion location, size, and type, margins taken, excised diameter, method of closure, and pathology report.
- Specialties:Dermatology, Plastic Surgery, Otolaryngology, Surgical Oncology
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center