If you are searching for a Mohs surgeon near me, you have probably been told you have a basal cell carcinoma, squamous cell carcinoma, or melanoma in situ on the face, ears, hands, or another cosmetically or functionally important area. Mohs micrographic surgery has the highest cure rate of any skin cancer treatment — about 99% for primary basal cell carcinoma and roughly 95% to 97% for squamous cell carcinoma — while preserving the most healthy tissue. The credential that matters most is American College of Mohs Surgery (ACMS) fellowship training, which is the recognized gold standard. Many dermatologists who are not ACMS-fellowship-trained also offer Mohs surgery, which is a real consumer-protection consideration worth understanding.
What a Mohs Surgeon Is and What They Do
A Mohs surgeon is a dermatologist who has completed dermatology residency followed by a 1-year fellowship in Mohs micrographic surgery and dermatologic oncology. The recognized fellowship is accredited through the American College of Mohs Surgery (ACMS), which has rigorous standards for case volume, faculty supervision, and curriculum. Fellowship-trained surgeons may also pursue subspecialty certification in Micrographic Dermatologic Surgery (MDS) through the American Board of Dermatology, a recognized subspecialty added in recent years, with certifying examinations now offered periodically.
Mohs surgery is a precise, layer-by-layer technique. The surgeon removes the visible tumor plus a thin margin, processes the tissue immediately in an on-site lab, examines the margins under a microscope, and removes additional layers only where cancer cells remain. The procedure ends when the margins are clear, typically requiring one to three stages over two to six hours. Reconstruction follows immediately and may involve simple closure, skin flaps, skin grafts, or referral to a plastic surgeon for complex defects. Mohs is most often used for non-melanoma skin cancers on the head, neck, hands, feet, and genitals, and increasingly for melanoma in situ and certain thin invasive melanomas.
When to See a Mohs Surgeon
Common indications include basal cell or squamous cell carcinoma on the face, ears, scalp, hands, feet, or genitals; recurrent skin cancers; large or aggressive tumors; tumors with poorly defined borders; tumors in immunosuppressed patients (transplant recipients, people with certain blood cancers); melanoma in situ on cosmetically sensitive areas; and certain rare skin cancers including dermatofibrosarcoma protuberans and microcystic adnexal carcinoma. The American Academy of Dermatology, ACMS, ASMS, and ASDS jointly publish Appropriate Use Criteria for Mohs surgery to guide referral decisions and identify when Mohs is (and is not) the best approach.
Patients usually arrive at the Mohs surgeon’s office after a biopsy by a dermatologist confirms a skin cancer in a high-risk location. Some Mohs surgeons also perform initial biopsies and full-body skin exams; many work in close collaboration with general dermatologists. Skin cancer is the most common cancer in the United States, and rates of basal and squamous cell carcinoma have continued to rise with population aging and cumulative sun exposure, so referrals for Mohs are common.
How to Find a Mohs Surgeon Near You
The ACMS Find a Mohs Surgeon tool at mohscollege.org lists fellowship-trained Mohs surgeons by location. The American Society for Dermatologic Surgery directory at asds.net is broader, including dermatologists offering surgical procedures whether or not they are ACMS-fellowship-trained. Both directories are useful, but the credential to verify specifically is ACMS fellowship completion. Your referring dermatologist’s recommendation, and referrals within an established cancer center, are also efficient routes.
Most academic medical centers, NCI-Designated Cancer Centers, and high-volume dermatology groups have ACMS-fellowship-trained Mohs surgeons on staff. Mohs surgery is procedure-volume sensitive; surgeons performing several hundred cases per year tend to have shorter procedure times, fewer stages per case on average, and more refined reconstruction skills.
How to Verify Credentials
Verify ABMS dermatology certification at certificationmatters.org. Then verify ACMS fellowship completion at mohscollege.org; only fellowship-trained surgeons are ACMS members. Some surgeons additionally hold the ABD subspecialty certification in Micrographic Dermatologic Surgery (MDS). State medical license verification is available through your state medical board, where you can also check for disciplinary history.
The credential question matters here more than in most fields. Any dermatologist can legally perform “Mohs surgery” in the United States; some have completed weekend or short-course training rather than a year-long fellowship. Outcomes data suggest fellowship-trained surgeons average fewer stages per case, shorter procedure times, and more sophisticated reconstruction approaches. ACMS-fellowship-trained surgeons are the recognized standard for complex cases and high-risk locations. It is reasonable to ask a surgeon directly, “Are you ACMS fellowship-trained?” and to confirm the answer in the directory.
What to Expect on Procedure Day
Mohs procedures are performed under local anesthesia in the surgeon’s office; you remain awake and comfortable throughout. After numbing the area, the surgeon removes the visible tumor plus a thin margin in the first stage. The tissue is mapped, frozen, sectioned, and stained in the on-site lab while you wait, typically 30 to 60 minutes per stage. The surgeon examines the entire margin under the microscope and either confirms clear margins (treatment ends) or returns to remove additional tissue precisely where cancer remains.
Most cases require one to three stages, though some complex tumors require more. Total time at the office ranges from two to six hours, often longer than patients expect. Bring snacks, a phone or book, and a companion who can drive home if local anesthesia includes vasoconstrictors that may cause transient dizziness. Once margins are clear, the surgeon discusses reconstruction options based on the size, depth, and location of the final defect.
Reconstruction may be a simple side-to-side closure with sutures, a skin flap that borrows tissue from a nearby area, a full-thickness or split-thickness skin graft, or a layered closure for deeper defects. Complex reconstructions (large defects on the nose, eyelid, or ear) may require referral to a plastic surgeon or oculoplastic surgeon, sometimes performed the same day or staged over a few days. Most patients leave with a pressure dressing in place, guidance on pain control, and detailed wound care instructions for the first one to two weeks.
Costs and Insurance Considerations
Mohs surgery is essentially always covered by Medicare and most commercial insurance for medically necessary skin cancer treatment. Total billed charges typically run roughly $1,000 to $3,000 per tumor for the Mohs procedure itself, with additional charges for complex reconstruction (flaps, grafts), pathology, and any associated visits. Out-of-pocket costs depend on your deductible, coinsurance, and in-network status, and these figures are estimates that vary by region and practice.
Self-pay rates, when they apply (uninsured patients, or the rare cosmetic indication), typically run about $2,000 to $5,000 for the procedure plus reconstruction. The procedure is performed in the office under local anesthesia, so in most cases there is no separate hospital outpatient facility fee. Importantly, do not delay evaluation or treatment of a diagnosed skin cancer because of cost concerns — untreated skin cancers grow, become harder and more expensive to remove, and can invade deeper tissue. Ask the office about financial assistance and payment options if cost is a barrier. Our healthcare costs guide covers how procedure and pathology charges combine in surgical billing.
Telehealth Options for Mohs Surgery
Mohs surgery itself is, of course, done in person. An initial consultation can sometimes happen by telehealth if recent biopsy reports and photographs are available, especially for established dermatology patients being referred internally within a system. Post-operative follow-up at one week and one month, and longer-term skin cancer surveillance, can incorporate teledermatology, especially for low-risk follow-up.
In-person evaluation matters when there is significant tumor extension, ambiguous lesion boundaries, multiple suspicious lesions, or any concern that requires palpation of the lesion or surrounding tissue. Our telehealth guide covers state licensing rules and the limits of virtual evaluation for skin cancer.
Skin Cancer Surveillance After Mohs
Patients who develop one non-melanoma skin cancer have a substantially elevated risk of additional skin cancers. The American Academy of Dermatology recommends regular full-body skin examinations after treatment, typically every 6 to 12 months, with the schedule individualized based on the type and location of the original tumor, immunosuppression status, and risk factors including significant sun exposure, fair skin, family history, and prior radiation therapy.
Self-examination matters between visits. Patients learn to monitor the surgical site for any signs of recurrence and to scan the surrounding skin for new lesions. The ABCDE criteria (Asymmetry, Border irregularity, Color variation, Diameter over 6 mm, Evolving appearance) help identify suspicious moles, though many skin cancers do not follow these patterns, and any new, changing, non-healing, or bleeding lesion warrants evaluation. Photo documentation of the full skin surface can help track changes over time. A spot that itches, crusts, or fails to heal over several weeks deserves a prompt look even if it does not match the ABCDE list.
Sun protection prevents new cancers and protects healing surgical sites. Daily broad-spectrum SPF 30 or higher sunscreen, sun-protective clothing, wide-brimmed hats, sunglasses, and avoidance of midday sun all reduce cumulative ultraviolet exposure. Patients with extensive actinic damage may benefit from field treatments including topical 5-fluorouracil, imiquimod, photodynamic therapy, or oral nicotinamide, all coordinated by their dermatologist. Annual full-body skin examinations remain the foundation of long-term skin cancer surveillance.
What to Bring to Your Pre-Op Consultation
Bring the original biopsy report and pathology slides if requested (the Mohs surgeon’s lab may want to confirm the histology). Bring a list of all medications and supplements, especially anticoagulants (warfarin, apixaban, rivaroxaban, dabigatran, enoxaparin), antiplatelet drugs (aspirin, clopidogrel), and supplements that can increase bleeding (fish oil, vitamin E, ginkgo, garlic, ginger, ginseng). Most Mohs surgeons continue medically necessary blood thinners through surgery to avoid clotting risk; do not stop any prescribed medication on your own — ask the office for specific instructions.
Bring a list of medical conditions, including any history of pacemakers or implanted defibrillators (relevant for electrocautery), bleeding disorders, contrast or local anesthetic allergies, prior radiation to the area, prior skin cancers in the area, and current immunosuppression. Plan for four to six hours at the office on procedure day; the timing depends on how many Mohs stages are needed before margins are clear.
Frequently Asked Questions
Why is Mohs surgery preferred for face and ear skin cancer?
Mohs has the highest cure rate of any skin cancer treatment — about 99% for primary basal cell carcinoma — while sparing the most healthy tissue. On the face, ears, and other cosmetically or functionally important areas, that combination matters more than for tumors elsewhere, where simple excision may be equally effective.
How is Mohs surgery different from regular skin cancer excision?
Standard excision removes the tumor with a wider margin and sends tissue to a pathology lab; results take days and examine only a sample of the margin. Mohs removes a precise margin, processes tissue immediately on site, examines essentially the entire margin microscopically, and removes additional layers only where cancer remains. Cure rates are higher and healthy-tissue removal is smaller.
Does insurance cover Mohs surgery?
Yes. Medicare and most commercial plans cover Mohs surgery for medically necessary skin cancer treatment when used for appropriate indications, which the AAD/ACMS Appropriate Use Criteria define. Confirm in-network status and any prior-authorization requirements with your plan.
Will I need reconstruction afterward?
Most Mohs cases require some form of reconstruction. Simple side-to-side closure is most common. Larger defects may need skin flaps, skin grafts, or referral to a plastic surgeon. The Mohs surgeon discusses options after the cancer is fully removed and the final defect is known.
How long does recovery take?
Most patients return to non-strenuous activity the day after surgery. Sutures typically come out in 5 to 14 days. Bruising and swelling resolve over two to three weeks. Final scar maturation takes 6 to 12 months. Sun protection at the surgical site is essential during healing.
The Bottom Line
A Mohs surgeon near you should be ABMS-board-certified in dermatology and ACMS-fellowship-trained, the recognized gold standard for Mohs micrographic surgery. The credential to verify is ACMS fellowship completion at mohscollege.org, not just the ability to legally offer Mohs surgery, which any licensed dermatologist can do. Insurance covers Mohs for medically appropriate skin cancers, cure rates are exceptional when the procedure is performed by experienced fellowship-trained surgeons, and tissue preservation matters most on the face, ears, and other cosmetically sensitive areas. Because skin cancer worsens when left untreated, do not delay care over cost — and the extra step to verify fellowship status meaningfully changes outcomes for complex cases.
This article is for general educational purposes only and is not medical advice. Diagnosis, candidacy for Mohs surgery, and treatment decisions are individual — consult a board-certified dermatologist or Mohs surgeon and confirm coverage with your insurer.
Sources
- American College of Mohs Surgery — Find a Mohs Surgeon; fellowship standards (mohscollege.org)
- American Board of Medical Specialties — Certification Matters (certificationmatters.org)
- American Board of Dermatology — Micrographic Dermatologic Surgery (MDS) subspecialty certification
- American Academy of Dermatology — Mohs Appropriate Use Criteria; skin cancer, ABCDE warning signs, and sun protection
- Medicare / CMS — coverage of medically necessary Mohs micrographic surgery