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, 99% for primary basal cell carcinoma, 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 by 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.
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 2 to 4 stages over 2 to 6 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 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, lymphoma patients); 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 published Appropriate Use Criteria for Mohs surgery to guide referral decisions.
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 biopsy and full-body skin exams; many work in close collaboration with general dermatologists.
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.
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 new ABD subspecialty certification in Micrographic Dermatologic Surgery (MDS). State medical license verification is available through your state medical board.
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.
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 1 to 3 stages, though some complex tumors require more. Total time at the office ranges from 2 to 6 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, prescriptions for pain control as needed, and detailed wound care instructions for the first 1 to 2 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 $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 deductible, coinsurance, and in-network status.
Self-pay rates, when applicable (uninsured patients, very rarely cosmetic indication), typically run $2,000 to $5,000 for the procedure plus reconstruction. The procedure is performed in the office under local anesthesia; there is no facility fee for hospital outpatient settings in most cases. Our healthcare costs guide covers how procedure and pathology charges combine in surgical billing.
Telehealth Options for Mohs Surgery
Mohs surgery itself, of course, is in person. 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 1 week, 1 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 6mm, Evolving appearance) help identify suspicious moles, though many skin cancers do not follow these patterns and any new or changing lesion warrants evaluation. Photo documentation of full-body skin can help track changes over time.
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 increase bleeding (fish oil, vitamin E, ginkgo, garlic, ginger, ginseng). Most Mohs surgeons continue these medications through surgery to avoid clotting risk; 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 4 to 6 hours at the office on procedure day; the timing depends on how many Mohs stages are needed before margins are clear.
When to seek emergency care: After Mohs surgery, heavy bleeding that does not stop with 20 minutes of firm direct pressure, expanding redness or streaking around the wound, fever above 101.5 F, severe pain not controlled by prescribed medication, or signs of significant infection require prompt medical attention. For severe symptoms, call 911 or go to the nearest emergency room rather than waiting for a follow-up appointment.
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, 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 is equivalent.
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. Mohs removes a precise margin, processes tissue immediately on site, examines all margins microscopically, and removes additional layers only where cancer remains. Cure rates are higher and 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).
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 2 to 3 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 performed by experienced fellowship-trained surgeons, and tissue preservation matters most on the face, ears, and other cosmetically sensitive areas. The extra step to verify fellowship status meaningfully changes outcomes for complex cases.