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Medical Author:

Nili N. Alai, MD, FAAD

Nili N. Alai, MD, FAAD

Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is Mohs micrographic surgery (MMS)? Why is the procedure called Mohs?
• Where can I have Mohs surgery, and how long does the surgery take?
• What kind of physician can perform Mohs surgery? Where can I find a doctor board-certified in Mohs?
• Is Mohs only for skin cancer?
• Am I a good candidate for Mohs surgery?
• What if I have artificial joints or other health issues?
• What areas are treatable by Mohs surgery?
• What are possible complications of Mohs?
• What is reconstruction? Will I have a scar?
• What are alternatives for Mohs surgery?
• What about insurance coverage and costs?
• How do I prepare for my surgery?
• How is recovery? Is it painful?
• How do I take care of my surgical area after Mohs surgery?
• What is the chance that my cancer will recur?
• How many "levels" of Mohs will I need?
• How are skin cancers treated?
• Find a local Dermatologist in your town
• Mohs Surgery Index

What are alternatives for Mohs surgery?

It is important to understand that there are alternative treatments and options to Mohs. Additional treatment choices include (but are not limited to) local radiation, prescription topical creams, plastic surgery, curettage and desiccation (scrape and burn), regular surgery, chemotherapy creams or injections, cryosurgery (deep freezing), photodynamic therapy (uses a type of light and a light-activated chemical called a photosenzitizer).

You may decide to have regular surgery with a plastic surgeon instead of having Mohs.

Alternatively, you may also choose a hybrid option where your Mohs surgeon removes the tumor and clears it for you and then you have the plastic surgeon fix up the wound and stitch it up for you.

If you prefer to have your plastic surgeon repair the wound, you will want to let your plastic surgeon and dermatologist know ahead of time and plan that into your Mohs schedule.

What about insurance coverage and costs?

Mohs surgery is generally considered a medical service and is not considered cosmetic. Currently, most insurance plans cover the procedure under their provided benefits. However, with the many changes in insurance plans, it is always advisable to contact your insurance carrier prior to scheduling surgery and confirm your eligibility and benefits.

Mohs, like any surgical procedure, will result in additional procedure charges above the routine office-visit fees. These surgical fees may range from $1,000-$2,000 depending on the area, number of Mohs levels, and the type of closure or repair required. The greater the number of levels required, the higher the cost. Surgical centers and hospitals usually have a much greater costs associated with a facility fee in addition to the surgery fee.

Insurance benefits vary and reimbursement depends on what benefits you have contracted for with your company. Currently, Medicare generally covers 80% of Mohs cancer surgery. If you have a secondary insurance plan, that may help take care of the remainder 20% not covered by Medicare.

Commercial or non-Medicare insurances currently generally cover a large percentage of your surgery unless you have to meet an out of pocket deductible first. You may want to get to know and understand your insurance benefits before having surgery. In many cases, you may also ask the billing office at the medical center or hospital for an approximate estimate of your charges before scheduling the procedure.