Valian
// Skin cancer surgery · 11602

Is skin cancer removal surgery covered by insurance?

Almost always yes. Once a biopsy confirms skin cancer, cutting it out is medically necessary and plans pay for it. Code 11602 covers a cancer removed from the trunk, arm, or leg where the lesion plus the healthy margin around it measures 1.1 to 2.0 centimeters. The surprises here are the extra lines, not the coverage.

Almost always

Covered once pathology confirms it

Size with margins

The billed size is the cancer plus the healthy margin around it, measured before cutting. That is why the code often lands higher than the consult suggested.

Three bills

One surgery can produce the removal, a separate closure line, and a pathology charge under 88305. Patients call about the second and the third.

10 day global

Suture removal and routine wound checks in the ten days after surgery are included. They post as 99024 at no cost, which surprises patients expecting a bill.

Deductible reality

This is surgery, so a patient with a full deductible owes real money. One check shows the amount left before the surgery date is set.

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Eligibility readout · 11602

Sample
Coverage
Active, $40 copay, referral approved
Frequency
No limit, referral required for the specialist
Patient share
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When 11602 is the right code

  • Pathology confirms the lesion is cancer
  • The site is trunk, arm, or leg
  • Cancer plus margins measures 1.1 to 2.0 cm
  • Excised whole, not shaved or destroyed

Documentation payers expect

Payers expect the pathology report, the measured size including margins, and the exact site. If a second wider removal follows, the note has to say why the first margins were not clear.

11602 or its neighbors?

11602
Skin cancer cut out, trunk, arm, or leg
11402
Same areas, but the growth is benign
17262
Cancer destroyed instead of cut out
17313
Mohs on trunk, arm, or leg

Picking the wrong neighbor is its own denial category. The chart decides, not the schedule.

Why a skin cancer excision gets denied

No confirmed pathology on the claim. Payers want the proven cancer diagnosis on the line, not a suspicious lesion code.
The measurement came off the specimen after it shrank, or is missing entirely. Size is recorded before the cut, cancer plus margins.
A simple closure was billed on its own line. Only layered or complex repair, such as 12032 or 13101 on these sites, bills apart from the removal.
The same lesion was billed twice when the surgeon went back for clear margins. The re excision needs its own note and the right modifier.

What lands on the bill after surgery

The specimen goes to pathology, so a second bill arrives weeks later under 88305, sometimes from an outside lab with its own network status. If the wound needed layers, 12032 or 13101 shows up as its own line and doubles what the patient expected. Routine follow up inside ten days is bundled into the surgery and shows on the record as 99024. If margins are not clear, a second removal or Mohs, 17313, follows and the deductible math starts over. Checking benefits first keeps that conversation calm.

11602, quick answers

Is skin cancer removal ever called cosmetic?

No. Once pathology confirms cancer, removal is medically necessary. Cosmetic questions only come up on benign growths.

Does Medicare cover 11602?

Yes, Medicare covers removing a biopsy proven skin cancer. It carries a ten day global period, so a routine wound check in that window is bundled and nothing is owed for it.

Why is there a separate line for the closure?

Because a layered or complex closure is its own service. A plain stitch line is already inside the removal fee and never bills on its own.

Why did the code change after the surgery?

Coding follows the measured size including margins and the final pathology, and that is often larger than what was described at the consult.

What if the doctor has to go back in?

A second removal for clear margins is usually covered, but it needs its own documentation and modifier. Recheck the deductible before that second surgery goes on the schedule.

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View all dermatology codes

Related: 11402 · 17262 · 17313

CPT is a registered trademark of the American Medical Association. This page is Valian's own plain-English summary for front-desk teams, not official CPT descriptor text, and is not billing or clinical advice. Coverage patterns are common plan behaviors; every plan differs. Verify benefits before the visit.