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Official Description

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 11606 refers to the excision of a malignant lesion from the trunk, arms, or legs, where the excised diameter exceeds 4.0 cm. This procedure involves the removal of not only the malignant tissue but also a margin of healthy tissue surrounding the lesion to ensure complete excision. Common types of malignant lesions that may be excised using this code include basal cell carcinoma, squamous cell carcinoma, verrucous carcinoma, and melanoma. The process begins with the cleansing of the area and the administration of a local anesthetic to minimize discomfort during the procedure. A careful identification of a healthy tissue margin is crucial, followed by a full-thickness incision made through the dermis. The incision is meticulously carried around the lesion, allowing for the complete excision of the malignant tissue. In some cases, a frozen section may be performed during the excision to verify that the margins are clear of malignant cells. If any malignant tissue is detected at the margins, additional tissue will be excised until all margins are confirmed to be clean. The excised lesion is then sent to a laboratory for histologic evaluation, which is separately reportable. To manage any bleeding that may occur during the procedure, electrocautery or chemical cautery techniques are employed. Finally, the surgical wound may be closed using a simple single-layer suture technique, although more complex methods such as intermediate (layer) closure, complex repair, skin grafts, or pedicle flaps may also be utilized depending on the specific circumstances of the excision.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 11606 is indicated for the excision of malignant lesions located on the trunk, arms, or legs. These lesions may include:

  • Basal Cell Carcinoma - A common form of skin cancer that arises from the basal cells in the epidermis.
  • Squamous Cell Carcinoma - A type of skin cancer that originates from squamous cells, which are flat cells found in the outer layer of the skin.
  • Verrucous Carcinoma - A variant of squamous cell carcinoma that is characterized by a slow-growing, warty appearance.
  • Melanoma - A serious form of skin cancer that develops from melanocytes, the cells that produce pigment in the skin.

2. Procedure

The procedure for excising a malignant lesion with CPT® Code 11606 involves several critical steps:

  • Step 1: Preparation - The area surrounding the malignant lesion is thoroughly cleansed to reduce the risk of infection. A local anesthetic is then injected to ensure the patient remains comfortable throughout the procedure.
  • Step 2: Identification of Margins - The surgeon identifies a margin of healthy tissue surrounding the lesion. This margin is essential to ensure that all malignant cells are removed during the excision.
  • Step 3: Incision - A full-thickness incision is made through the dermis, carefully encircling the lesion. This incision allows for the complete removal of the malignant tissue along with the designated margin of healthy tissue.
  • Step 4: Excision - The entire lesion, along with the surrounding healthy tissue, is excised. If necessary, a frozen section may be performed at this stage to check for clear margins. If malignant cells are found at the margins, additional tissue is excised until all margins are confirmed to be free of malignancy.
  • Step 5: Laboratory Evaluation - The excised lesion is sent to a laboratory for histologic evaluation, which is separately reportable. This evaluation is crucial for determining the nature of the lesion and ensuring complete removal.
  • Step 6: Hemostasis - Any bleeding that occurs during the procedure is controlled using electrocautery or chemical cautery techniques to minimize blood loss.
  • Step 7: Wound Closure - The surgical wound may be closed using a simple single-layer suture technique. Depending on the complexity of the excision, other closure methods such as intermediate (layer) closure, complex repair, skin grafts, or pedicle flaps may also be employed.

3. Post-Procedure

After the excision procedure, patients are typically monitored for any immediate complications. Post-procedure care may include instructions on wound care to prevent infection and promote healing. Patients may be advised on signs of infection or complications to watch for, such as increased redness, swelling, or discharge from the surgical site. Follow-up appointments may be scheduled to assess the healing process and to discuss the results of the histologic evaluation. The recovery period can vary depending on the extent of the excision and the method of closure used.

Short Descr EXC TR-EXT MAL+MARG >4 CM
Medium Descr EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM
Long Descr Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5A - Ambulatory procedures - skin
MUE 2
CCS Clinical Classification 170 - Excision of skin lesion
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC This service has been performed in part by a resident under the direction of a teaching physician
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
LT Left side (used to identify procedures performed on the left side of the body)
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
RT Right side (used to identify procedures performed on the right side of the body)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
SG Ambulatory surgical center (asc) facility service
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
73 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CG Policy criteria applied
CR Catastrophe/disaster related
FS Split (or shared) evaluation and management visit
GA Waiver of liability statement issued as required by payer policy, individual case
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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2013-01-01 Changed Description Changed
2003-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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