Dermatology CPT Codes
Dermatology billing turns on three questions: what technique was used, how many lesions, and how big. Biopsy codes split by technique, destruction codes split by whether the lesion is premalignant or benign, and excision codes price by diameter including margins. Small documentation gaps here, like a missing size, downgrade claims all day long.
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Dermatology CPT codes
Skin Biopsy, Tangential, First Lesion
Shave-technique biopsy of a single lesion. Additional tangential biopsies use add-on 11103.
Skin Biopsy, Punch, First Lesion
Punch-technique biopsy including simple closure. Add-on 11105 for each additional.
Destruction, Premalignant Lesion, First
Destruction of the first premalignant lesion, typically actinic keratosis, by cryotherapy or other method.
Destruction, Premalignant Lesions 2–14 (Add-on)
Each additional premalignant lesion after the first, billed per lesion alongside 17000.
Destruction, Benign Lesions, Up to 14
One code covering destruction of up to 14 benign lesions such as warts.
Excision, Benign Lesion, Trunk/Arms/Legs, ≤0.5 cm
Benign excision priced by size and site. The 11400 family scales up with excised diameter.
Excision, Benign Lesion, Face/Ears/Lips, ≤0.5 cm
Facial benign excisions pay more than trunk. Same size-based laddering.
Codes in blue have full detail pages with documentation requirements, billing mistakes, and FAQ.
Dermatology billing notes
Biopsy codes changed in 2019 and the old 11100/11101 are gone. Today's codes go by technique: 11102 tangential (shave), 11104 punch, 11106 incisional, each with its own add-on for additional lesions.
Destruction splits by lesion type. Premalignant lesions like actinic keratoses use 17000 for the first and 17003 for each of the second through fourteenth. Benign lesions use 17110 for up to 14 in one code.
Excision codes price by the excised diameter, which means lesion plus margins, measured before the specimen shrinks in formalin. Document the size in the note, not just the path report.
Excisions carry a 10-day global period; biopsies and destructions have none. A same-day E&M visit alongside a minor procedure needs modifier 25 and its own documentation.
When a biopsy and an excision happen at different sites on the same day, distinct-site documentation and modifier 59 (or XS) keep the biopsy from bundling into the excision.
Frequently asked questions about dermatology billing
How do I bill multiple skin biopsies in one visit?▼
First biopsy gets the primary code for its technique (11102 tangential, 11104 punch, 11106 incisional), and each additional biopsy gets the matching add-on (11103, 11105, 11107). When techniques differ, the highest-valued technique is primary and the others bill as add-ons.
What's the difference between destruction codes 17000 and 17110?▼
Lesion type. 17000 and its add-on 17003 are for premalignant lesions like actinic keratoses, billed per lesion. 17110 covers benign lesions like warts, up to 14 of them in a single flat code. Using the premalignant codes for benign lesions is a common audit finding.
Why did my excision claim downcode?▼
Almost always the size. Excision codes ladder by excised diameter, lesion plus margins, and when the note doesn't state it, coders default to the smallest size or the payer downcodes the claim. Measure before excision and write it in the procedure note.
Sources
- Code set structure and updates: American Medical Association — CPT
- Fee schedule and component billing rules: CMS Medicare Physician Fee Schedule
- How we research and verify: our editorial policy
CPT® is a registered trademark of the American Medical Association. Content on this page is original educational writing, not a reproduction of AMA-copyrighted descriptions. Verify codes and payer rules before billing.