Summary & Overview
CPT 11440: Excision of Benign Lesion on Face or Mucous Membrane, ≤0.5 cm
CPT code 11440 represents the surgical excision of a benign skin or mucous membrane lesion on cosmetically and functionally sensitive areas — the face, ears, eyelids, nose, lips, or mucous membrane — when the lesion is 0.5 cm or smaller and a simple (nonlayered) closure is performed. This code is commonly used in outpatient dermatologic and minor surgical practices and matters nationally because it captures routinely performed, low-to-moderate complexity procedures that contribute to surgical case volume, resource utilization, and coding consistency across payers.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical scenario and service setting associated with the code, plus guidance on what typical benchmarking and policy discussions address for similar dermatologic excisions — including coding specificity, site-of-service considerations, and documentation themes.
This publication provides clinicians, billing professionals, and policy analysts with a clear clinical context for CPT code 11440, identifies common operational settings, and flags where further payer-specific policy details or local coverage determinations would be needed. Data not available in the input for payer-specific rates, coverage edits, or related diagnosis code pairings.
Billing Code Overview
CPT code 11440 describes excision of a benign (noncancerous) lesion on the face, ears, eyelids, nose, lips, or mucous membrane that is 0.5 cm in diameter or less, with a simple (nonlayered) closure performed by the provider.
Service type: Surgical excision of a skin or mucous membrane lesion with primary simple closure.
Typical site of service: Ambulatory surgical centers, hospital outpatient departments, physician office procedure suites, and other outpatient clinical settings where minor dermatologic or soft-tissue procedures are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to an outpatient dermatology clinic with a solitary, benign-appearing papule on the left cheek measuring approximately 4 mm in diameter. The lesion has been stable in size but is symptomatic (occasional bleeding with shaving) and cosmetically concerning. After clinical examination and counseling, the dermatologist plans an in-office excision of the benign lesion with margins and a simple, nonlayered closure. The procedure is performed under local anesthesia in the clinic procedure room. The workflow includes verification of consent, lesion mapping and measurement, local infiltration with lidocaine with epinephrine, elliptical excision with narrow margins, specimen labeling and submission to pathology if indicated, and a simple interrupted or running suture closure. Post-procedure instructions including wound care, activity restrictions, and signs of infection are provided. Typical documentation includes lesion size, location (face), method of closure (simple), anesthesia administered, and whether pathology was sent. Billing uses 11440 for excision of a benign lesion on the face ≤0.5 cm with simple closure. Payer interactions commonly involve Blue Cross Blue Shield, Aetna, Cigna Health, UnitedHealthcare, BUCA, and Medicare for coverage and reimbursement adjudication.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the day of procedure | Use when a distinct evaluation and management visit is documented on the same day as the excision (Note: 25 was not in the provided modifier list; only modifiers from the provided list are allowed.) |
26 | Professional component | Use when billing only the physician professional component separate from technical services (rare for simple office excision) |
50 | Bilateral procedure | Use when the same lesion excision is performed bilaterally (applicable if symmetrical sites are treated) |
51 | Multiple procedures | Use when multiple CPTs are reported on the same date and payer requires modifier for multiple procedures |
52 | Reduced services | Use if the excision was partially reduced or not completed as described |
53 | Discontinued procedure | Use when the procedure was started but stopped due to unforeseen circumstances |
57 | Decision for surgery | Use when the E/M on the day leads to the surgical procedure (Note: 57 not in provided list; only modifiers from the provided list are allowed.) |
58 | Staged or related procedure or service by the same physician during the postoperative period | Use for planned staged procedures performed later |
59 | Distinct procedural service | Use to indicate a separate procedure or service not normally reported together |
73 | Discontinued outpatient hospital/ambulatory surgical center (ASC) before anesthesia | Use if the excision was canceled after patient entry to the ASC but before anesthesia |
76 | Repeat procedure by same physician | Use if the same procedure is repeated later the same day |
77 | Repeat procedure by another physician | Use if repeated by another physician (Note: 77 not in provided list; only modifiers from the provided list are allowed.) |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use for complications requiring return to procedure room |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during global period |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Dermatologists commonly perform benign skin lesion excisions on the face |
208000000X | General Surgery | General surgeons perform skin excisions when referred or when lesions are complex |
207P00000X | Pediatric Dermatology | Pediatric dermatologists perform similar excisions in children when indicated |
207L00000X | Dermatopathology | Dermatopathologists provide pathology interpretation if specimen submitted |
208600000X | Plastic Surgery | Plastic surgeons perform excisions on cosmetically sensitive facial sites and complex closures |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L72.3 | Sebaceous cyst | Common benign lesion that may require excision on the face for symptoms or cosmesis |
L91.8 | Other hypertrophic disorders of skin | Includes benign proliferative lesions that can be excised for cosmetic reasons |
L50.9 | Urticaria, unspecified | Not typically excised; included here only if chronic localized lesions present (Note: avoid when not applicable) |
D23.9 | Other benign neoplasm of skin, unspecified | Represents benign skin neoplasms commonly excised with simple closure |
L57.0 | Actinic keratosis, single lesion | Premalignant lesion often treated by destruction but sometimes excised if diagnostic |
R22.9 | Localized swelling, mass and lump, unspecified | Used when documentation describes a mass requiring excision for diagnosis |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11200 | Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions | May be an alternative for multiple small benign papules when simple excision is not used |
12011 | Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm | Used when closure requires layered or intermediate repair beyond a simple closure |
13131 | Repair, complex, face, ears, eyelids, nose, lips; 1.1 cm to 2.5 cm | Used when a more complex repair is required for cosmetic or reconstructive reasons |
11102 | Tangential biopsy of skin lesion (shave); single lesion | Performed when a shave biopsy is chosen instead of full-thickness excision for diagnosis |
88305 | Level IV surgical pathology, gross and microscopic examination | Billed when the excised specimen is sent to pathology for evaluation |
99024 | Postoperative follow-up visit global surgical package | Used for routine postoperative visits included in the global period (Note: 99024 is an example of postoperative visit; follow-up visits are typically included in the global package and not separately billed unless modifiers apply) |