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Official Description

Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 11641 involves the excision of a malignant lesion located on the face, ears, eyelids, nose, lips, or mucous membranes, with an excised diameter ranging from 0.6 to 1.0 cm. This procedure is typically performed to remove cancerous growths, which may include types such as basal cell carcinoma, squamous cell carcinoma, verrucous carcinoma, and melanoma. The excision is conducted with the intent to not only remove the malignant tissue but also to include a margin of healthy tissue surrounding the lesion to ensure complete removal and minimize the risk of recurrence. Prior to the excision, the area is thoroughly cleansed, and a local anesthetic is administered to ensure patient comfort during the procedure. A full-thickness incision is made through the dermis, carefully encircling the lesion to excise it completely. 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, further excision is carried out until all margins are confirmed to be free of cancerous cells. The excised lesion is then sent for histologic evaluation to assess the nature of the tissue. To manage any bleeding that may occur during the procedure, electrocautery or chemical cautery techniques are employed. After the excision, the surgical wound may be closed using a simple single-layer suture technique, although more complex closure 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 and the size of the wound.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 11641 is indicated for the excision of malignant lesions located on the face, ears, eyelids, nose, lips, or mucous membranes. The specific conditions or symptoms that may warrant this procedure include:

  • Basal Cell Carcinoma - A common type of skin cancer that typically appears as a small, shiny bump or a sore that does not heal.
  • Squamous Cell Carcinoma - A type of skin cancer that may present as a firm, red nodule or a flat lesion with a scaly, crusted surface.
  • Verrucous Carcinoma - A variant of squamous cell carcinoma that is characterized by a slow-growing, wart-like appearance.
  • Melanoma - A serious form of skin cancer that can develop from moles or appear as a new, unusual growth on the skin.

2. Procedure

The procedure for excising a malignant lesion as described by CPT® Code 11641 involves several critical steps:

  • Step 1: Preparation - The area surrounding the malignant lesion is cleansed thoroughly 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 to ensure complete excision of the malignant cells. This margin is crucial for minimizing the risk of cancer recurrence.
  • Step 3: Incision - A full-thickness incision is made through the dermis, carefully encircling the lesion. The incision is designed to remove the entire lesion along with the identified margin of healthy tissue.
  • Step 4: Excision - The surgeon excises the lesion completely, ensuring that all malignant tissue is removed. If necessary, a frozen section may be performed at this stage to check for clear margins.
  • Step 5: Additional Excision (if needed) - If malignant cells are detected at the margins during the frozen section analysis, additional tissue is excised until all margins are confirmed to be free of cancerous cells.
  • Step 6: Histologic Evaluation - The excised lesion is sent to the laboratory for histologic evaluation to determine the nature of the tissue and confirm the diagnosis.
  • Step 7: Hemostasis - Any bleeding that occurs during the procedure is controlled using electrocautery or chemical cautery techniques to ensure a clean surgical field.
  • Step 8: Wound Closure - The surgical wound may be closed using a simple single-layer suture technique. Depending on the size and complexity of the wound, other closure methods such as intermediate (layer) closure, complex repair, skin grafts, or pedicle flaps may 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 promote healing and prevent infection. Patients may be advised to keep the area clean and dry, and to follow up with their healthcare provider for suture removal or further evaluation of the excised tissue. Recovery time can vary based on the size and location of the excised lesion, as well as the method of closure used. It is important for patients to report any signs of infection, such as increased redness, swelling, or discharge from the wound, to their healthcare provider promptly.

Short Descr EXC F/E/E/N/L MAL+MRG 0.6-1
Medium Descr EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM
Long Descr Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 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 Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
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).
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.
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.)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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.)
GA Waiver of liability statement issued as required by payer policy, individual case
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.
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.
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.
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
E1 Upper left, eyelid
E2 Lower left, eyelid
E3 Upper right, eyelid
E4 Lower right, eyelid
GC This service has been performed in part by a resident under the direction of a teaching physician
GE This service has been performed by a resident without the presence of a teaching physician under the primary care exception
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
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
LT Left side (used to identify procedures performed on the left side of the body)
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
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
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
SG Ambulatory surgical center (asc) facility service
X3 Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2003-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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