Top 25 Micrographic Dermatologic Surgery (mds) Specialists Across the US
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What is a Mohs Surgeon?
Learn about this specialty, training requirements, and when to schedule a visit.
A Mohs surgeon is a physician who specializes in Mohs micrographic surgery, a precise surgical technique for removing skin cancers while preserving maximum healthy tissue. These fellowship-trained specialists combine dermatology expertise with advanced surgical skills to treat basal cell carcinoma, squamous cell carcinoma, and select melanomas. Mohs surgeons examine 100% of the tumor margins in real-time during surgery, achieving cure rates of up to 99% for primary skin cancers while minimizing scarring through tissue-sparing techniques and expert facial reconstruction.
Training and Qualifications
Becoming a mohs surgeon requires extensive education and training:
- 4 years of medical school to earn an MD or DO degree
- Completion of a dermatology residency (4 years including internship)
- 1-2 year ACGME-accredited Mohs micrographic surgery and dermatologic oncology fellowship
- Total of 12-14 years of education and training beyond high school
- Fellowship includes training in histopathology, complex reconstruction, and management of high-risk skin cancers
Board Certification: American Board of Dermatology with subspecialty certification in Micrographic Dermatologic Surgery. Fellowship training through ACGME-accredited programs ensures expertise in tumor removal, margin analysis, and reconstructive surgery. The American College of Mohs Surgery (ACMS) maintains additional standards for fellowship-trained Mohs surgeons.
When Should You See a Mohs Surgeon?
You should consider seeing a mohs surgeon if:
- You have been diagnosed with basal cell carcinoma or squamous cell carcinoma
- Your skin cancer is located on the face, ears, nose, lips, eyelids, or hands
- You have a recurrent skin cancer that has returned after previous treatment
- Your skin cancer has aggressive features or unclear margins on biopsy
- You want to preserve maximum tissue in cosmetically sensitive areas
- You have multiple skin cancers requiring treatment
- You have melanoma in situ in certain locations appropriate for Mohs technique
Key Facts
Common Conditions Treated
Mohs Surgeons are trained to diagnose and treat a wide range of conditions. Here are some of the most common conditions that mohs surgeons help patients manage.
Basal Cell Carcinoma (BCC)
The most common form of skin cancer, arising from basal cells in the epidermis. While rarely metastatic, BCCs can be locally destructive if untreated.
Key Symptoms
Treatment Approach
Mohs surgery removes basal cell carcinomas layer by layer while examining margins in real-time, achieving 99% cure rates for primary BCCs while preserving maximum healthy tissue, especially important for facial tumors.
Squamous Cell Carcinoma (SCC)
The second most common skin cancer, arising from squamous cells. SCCs have higher metastatic potential than BCCs, particularly high-risk variants.
Key Symptoms
Treatment Approach
Mohs surgery is particularly valuable for high-risk SCCs on the face, ears, and lips, providing complete margin control and achieving cure rates of 94-97% even for aggressive tumors.
Melanoma In Situ
Early-stage melanoma confined to the epidermis without dermal invasion. When appropriate, Mohs or modified Mohs techniques can be used for precise margin control.
Key Symptoms
Treatment Approach
Select Mohs surgeons trained in melanoma techniques use modified Mohs or staged excision with rush permanent sections to achieve complete margin clearance while preserving tissue in cosmetically sensitive areas like the face.
Dermatofibrosarcoma Protuberans (DFSP)
A rare, slow-growing soft tissue sarcoma of the skin with high local recurrence rates when treated with standard excision.
Key Symptoms
Treatment Approach
Mohs surgery is the gold standard for DFSP treatment, with recurrence rates of less than 1% compared to 20-50% with standard excision, due to complete margin examination of this infiltrative tumor.
Recurrent Skin Cancer
Skin cancers that return after previous treatment with excision, radiation, or other modalities, often having irregular growth patterns.
Key Symptoms
Treatment Approach
Mohs surgery excels at treating recurrent cancers because it can trace irregular tumor extensions through scar tissue, achieving 94% cure rates for recurrent BCCs compared to lower rates with repeat standard excision.
Facial Reconstruction After Skin Cancer
Complex wound closure and reconstruction required after removal of skin cancers from cosmetically and functionally sensitive facial areas.
Key Symptoms
Treatment Approach
Mohs surgeons are trained in advanced reconstructive techniques including local flaps, skin grafts, and complex closures to achieve optimal functional and cosmetic outcomes while ensuring complete cancer removal.
Periocular Skin Cancer
Skin cancers involving the eyelids, medial canthus, or surrounding eye area requiring precise removal to preserve vision and eye function.
Key Symptoms
Treatment Approach
Mohs surgery provides precise margin control for periocular tumors while maximizing tissue preservation critical for eyelid function. Many Mohs surgeons work with oculoplastic surgeons for complex reconstructions.
Extramammary Paget's Disease
A rare intraepithelial adenocarcinoma typically affecting the genital or perianal region with extensive subclinical spread.
Key Symptoms
Treatment Approach
Mohs surgery is valuable for this condition because clinical margins poorly correlate with histologic extent. Complete margin examination helps achieve clearance while minimizing tissue removal in sensitive anatomic areas.
Important Note
This list represents common conditions but is not exhaustive. Mohs Surgeons treat many other conditions related to their specialty. If you're experiencing symptoms or have concerns, consult with a qualified mohs surgeon for a proper evaluation.
What to Expect During Your Visit
Understanding what happens during your appointment can help you feel more prepared. Here's what you can typically expect when visiting a mohs surgeon.
Your First Visit
- Review of your skin cancer diagnosis including biopsy pathology results
- Examination of the tumor site and assessment of clinical margins
- Discussion of why Mohs surgery is appropriate for your specific cancer
- Explanation of the Mohs procedure, reconstruction options, and expected outcomes
- Review of your medical history, medications, and any bleeding risk factors
- Discussion of what to expect on surgery day including timing and logistics
- Pre-operative consultation typically lasts 20-30 minutes
Diagnosis & Testing
- Review of biopsy pathology: tumor type, differentiation, and high-risk features
- Clinical examination to assess visible tumor extent and plan initial margins
- Dermoscopy or other imaging to better define tumor borders in select cases
- Photography to document pre-operative appearance and tumor location
- Assessment of surrounding anatomy important for reconstruction planning
- Evaluation of any prior treatment and scarring that may affect surgery
Treatment Options
- Local anesthesia injection to numb the surgical area (most patients need only local anesthesia)
- Removal of visible tumor with a thin margin of surrounding tissue (first stage)
- Mapping and processing of tissue with frozen sections while you wait
- Microscopic examination of 100% of surgical margins by the Mohs surgeon
- Additional stages as needed until all margins are cancer-free (typically 1-3 stages)
- Reconstruction of the surgical defect using the most appropriate technique
- Post-operative wound care instructions and follow-up scheduling
Tip for Your Visit
Bring a list of current medications, previous test results, and questions you want to ask. Writing down your symptoms—when they occur and what affects them—helps your mohs surgeon provide accurate diagnosis and effective treatment.
How to Choose the Right Mohs Surgeon
Finding the right healthcare provider is important for your health and peace of mind. Here are key factors to consider when selecting a mohs surgeon.
Credentials to Verify
- Completion of ACGME-accredited Mohs micrographic surgery fellowship
- Board certification by the American Board of Dermatology
- Membership in the American College of Mohs Surgery (ACMS) indicates fellowship training
- Active, unrestricted medical license in your state
- Hospital privileges or accredited outpatient surgical facility
- Ongoing continuing medical education in Mohs surgery and dermatologic oncology
Important Considerations
- Fellowship training from an ACGME-accredited Mohs surgery program
- Volume of Mohs cases performed annually (experience matters for complex tumors)
- Expertise in reconstruction, especially for your tumor location
- Access to specialized reconstruction if needed (oculoplastic, ENT collaboration)
- Patient reviews and before/after photos of reconstruction results
- Office location and ability to accommodate multiple stages in one day
- Clear communication about the procedure, expected outcomes, and costs
Quick Tip
Don't hesitate to schedule consultations with multiple mohs surgeons before making your decision. The right fit isn't just about credentials—it's also about feeling comfortable and confident in your care.
Cost and Insurance Information
Understanding the costs associated with seeing a mohs surgeon can help you plan for your healthcare needs.
Average Costs (Without Insurance)
Initial Visit
$150-$350 (pre-operative consultation)
Follow-up Visit
$100-$200
Common Procedures
Note: These are estimated average costs and can vary based on location, provider, and specific services required.
Insurance Coverage
- Most health insurance plans cover Mohs surgery when medically indicated for skin cancer
- Mohs surgery is billed per stage, with separate charges for pathology and reconstruction
- Pre-authorization may be required by some insurance plans before surgery
- In-network Mohs surgeons will have negotiated rates reducing your out-of-pocket costs
- Reconstruction is typically covered as part of the medically necessary cancer treatment
- High-deductible plans may result in significant out-of-pocket costs for first procedure of year
Medicare Information
Medicare Part B covers Mohs surgery at 80% of the approved amount after the deductible. Each stage of surgery, pathology processing, and reconstruction is billed separately. Medicare considers Mohs surgery appropriate for specific indications including facial skin cancers and recurrent tumors. The Women's Health and Cancer Rights Act requires coverage of reconstruction.
Money-Saving Tips
- 1Always verify your mohs surgeon is in-network before scheduling
- 2Ask about self-pay discounts if you don't have insurance
- 3Inquire about payment plans for expensive procedures
- 4Get prior authorization when required to avoid claim denials
- 5Use FSA or HSA funds for eligible medical expenses
Questions to Ask Your Mohs Surgeon
Being prepared for your appointment helps you get the most out of your time with your doctor. Here are important questions to consider asking a mohs surgeon.
Did you complete an ACGME-accredited Mohs surgery fellowship?
How many Mohs cases do you perform each year?
Do you have experience with my specific type of skin cancer?
What reconstruction technique do you anticipate using for my wound?
Will you perform the reconstruction yourself or refer to another specialist?
What cure rate can I expect for my specific tumor?
How many stages do you typically need for tumors like mine?
What should I do if I have a problem after the surgery?
When will I need follow-up appointments for skin cancer surveillance?
Do you have before-and-after photos of similar reconstructions I can see?
Pro Tip
Write down your questions before your appointment and bring them with you. Don't hesitate to take notes during your visit or ask for written instructions.
When to Seek Emergency Care
Know when symptoms require immediate attention versus a scheduled appointment.
While most conditions can wait for a scheduled appointment with a mohs surgeon, certain symptoms require immediate emergency care. Go to the emergency room or call 911 if you experience:
- Significant bleeding from surgical site that does not stop with 20 minutes of firm pressure
- Signs of infection: increasing redness spreading beyond wound edges, fever over 101°F, pus drainage
- Severe swelling around the eye after periocular surgery that affects vision
- Signs of skin flap or graft failure: color change to blue/black, loss of warmth
- Severe pain not controlled by prescribed medications
- Any new neurological symptoms such as facial weakness or numbness beyond expected surgical area
EMERGENCY
Call 911 or nearest ER
URGENT
Doctor or urgent care
NON-URGENT
Regular appointment
Mohs Surgeon vs. Other Specialists
Understanding the differences between medical specialists helps you choose the right provider for your needs.
Mohs Surgeon vs. Dermatologist
A general dermatologist diagnoses and treats a wide range of skin conditions and may perform standard excisions or refer to Mohs surgeons for appropriate cases. A Mohs surgeon has completed additional fellowship training specifically in Mohs micrographic surgery and complex reconstruction. Not all dermatologists perform Mohs surgery, and those who do should have fellowship training.
Mohs Surgeon vs. Plastic Surgeon
Plastic surgeons are experts in reconstruction and may perform standard skin cancer excisions. However, they typically do not examine surgical margins in real-time like Mohs surgeons. For skin cancers where margin control is critical (face, recurrent tumors), Mohs surgery with immediate reconstruction often provides superior outcomes. Some complex reconstructions may involve collaboration between Mohs and plastic surgeons.
Mohs Surgeon vs. Head and Neck Surgeon (ENT)
Head and neck surgeons (ENT/otolaryngologists) treat cancers of the head and neck region including some skin cancers, particularly those involving the ear or nose cartilage. Mohs surgeons specialize specifically in skin cancer with real-time margin analysis. These specialties often collaborate, with Mohs surgeons removing tumor and ENT surgeons performing complex nasal or ear reconstruction.
Not sure which specialist you need?
Your primary care physician can help determine the right specialist for your condition and provide a referral if needed.
Sources & References
Information about mohs surgeons is sourced from peer-reviewed medical literature and authoritative organizations.
Last updated: March 2026
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Frequently Asked Questions
Common questions about micrographic dermatologic surgery (mds) specialists
What is the advantage of Mohs surgery over standard excision?
Mohs surgery examines 100% of the surgical margins in real-time, compared to standard excision which samples only about 1% of margins. This provides cure rates of up to 99% for primary basal cell carcinomas versus 90-95% for standard excision. Mohs also removes only cancer-containing tissue, preserving maximum healthy tissue - particularly important on the face where every millimeter matters for appearance and function.
How long does Mohs surgery take?
Most Mohs procedures take 2-4 hours total, but you should plan to be at the office for most of the day. The actual surgery time is relatively short (15-30 minutes per stage), but processing and examining the tissue takes 30-60 minutes per stage. Most cancers are cleared in 1-3 stages. Complex tumors may require additional stages. Reconstruction adds additional time depending on complexity.
Is Mohs surgery painful?
Mohs surgery is performed under local anesthesia, similar to having a dental procedure. You will feel pressure but not sharp pain during the surgery. Most patients tolerate the procedure very well without sedation. After surgery, discomfort is typically managed with over-the-counter pain medication. The waiting periods between stages are the most challenging aspect for some patients.
Will I have a large scar after Mohs surgery?
Mohs surgery is designed to minimize scarring by removing only the cancer-containing tissue. Mohs surgeons are trained in reconstructive techniques to optimize cosmetic outcomes. While any surgery leaves some scarring, the results are typically excellent. Most scars continue to improve over 6-12 months. Your surgeon will discuss expected outcomes based on your specific tumor size and location.
Can Mohs surgery treat melanoma?
Mohs surgery with modified techniques can treat melanoma in situ (early, non-invasive melanoma) in select situations, particularly on the face where tissue conservation is important. However, invasive melanomas typically require wide local excision with standard margins and possible sentinel lymph node biopsy. Your dermatologist will recommend the appropriate treatment based on your melanoma type and stage.
Medical disclaimer: This content is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you have a medical emergency, call 911. Our editorial standards