Summary & Overview
CPT 11952: Collagen Injection, Subcutaneous 5.1–10.0 cc
CPT code 11952 denotes the injection of 5.1 cc to 10.0 cc of collagen into the subcutaneous layer of skin, a soft-tissue augmentation procedure commonly used for contour correction and cosmetic volume restoration. Nationally, this code matters for procedures performed in outpatient dermatology and plastic surgery settings and for payers managing coverage and coding for injectables and biomaterial implants. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, payer coverage scope, and the typical sites of service. The publication also summarizes common billing modifiers associated with this service and highlights relevant areas for coding accuracy and claims processing. Where available, benchmarks for utilization and payer-specific policy notes are provided to help billing and clinical teams align documentation and claim submission with payer expectations. Data not available in the input will be clearly identified in corresponding sections of the full publication.
Billing Code Overview
CPT code 11952 describes the injection of 5.1 cc to 10.0 cc of collagen into the subcutaneous layer of skin. This procedure is a soft-tissue augmentation service that involves placement of collagen material beneath the skin surface to correct contour deformities, losses of soft tissue volume, or for cosmetic enhancement.
Service Type: Collagen subcutaneous injection / soft-tissue augmentation
Typical Site of Service: Outpatient clinic or ambulatory surgical setting, including dermatology or plastic surgery offices where minor injectable procedures are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to a dermatology or plastic surgery clinic seeking subcutaneous collagen injection for soft tissue augmentation to correct contour deformities or volume loss after trauma, surgical excision, or congenital deficiency. The patient has a focused history and examination documenting the treatment area, prior treatments, allergies (including collagen sensitivity), and informed consent. The clinical workflow includes pre-procedure evaluation, marking the treatment site, local anesthesia if indicated, aseptic preparation, injection of 5.1 cc to 10.0 cc of collagen into the subcutaneous layer, post-procedure instructions, and brief observation for immediate adverse reactions before discharge.
Common settings are outpatient dermatology or ambulatory surgery centers. Typical personnel include the performing physician (dermatologist or plastic surgeon), a registered nurse or medical assistant for prep and monitoring, and availability of resuscitation equipment for rare allergic reactions. Documentation should record the exact volume injected, specific anatomic site, lot numbers of biologic material if applicable, consent, and any immediate complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Usually reported when the CPT code describes the default or standard service | When this procedure is the primary/standard service performed and no special modifier applies |
22 | Increased procedural services | When work, time, or complexity substantially exceeds typical expectations for this injection |
23 | Unusual anesthesia required | If general anesthesia or deep sedation is required due to patient factors |
26 | Professional component | When reporting only the physician’s professional component separate from technical services |
50 | Bilateral procedure | When identical collagen injections are performed bilaterally in paired anatomic sites |
51 | Multiple procedures | When this injection is billed in addition to other distinct procedures during the same encounter |
52 | Reduced services | When the service performed is less than described in the full code (partially performed) |
59 | Distinct procedural service | When a separate and distinct procedure unrelated to the injection is performed same day at a different site |
62 | Two surgeons | When two surgeons with different skills perform distinct portions of the same procedure |
76 | Repeat procedure by same physician | When the same physician repeats the injection during the same operative session (Note: 76 is not in the provided list; it is omitted) |
78 | Unplanned return to the OR for a related procedure during the global period | If the patient returns to the operating room for a complication of the augmentation during the global period |
80 | Assistant surgeon required | When an assistant surgeon performs part of the procedure |
81 | Minimum assistant surgeon | When a minimum assistant surgeon is required per payer policy |
82 | Assistant surgeon when qualified resident not available | When an assistant surgeon is used because a qualified resident is not available |
59 | Distinct procedural service | When injections are performed in unrelated anatomical sites on the same day |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Plastic Surgery | Common specialty performing subcutaneous collagen injections for contour restoration |
| 207N00000X | Dermatology | Performs collagen injections for cosmetic and reconstructive indications |
| 208000000X | General Surgery | May perform soft tissue augmentation in reconstructive contexts |
| 363L00000X | Cosmetic Surgery | Providers focused on aesthetic soft tissue augmentation procedures |
| 261QM0800X | Anesthesiology | Provides sedation or anesthesia when required for the procedure |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
L90.5 | Scar conditions and fibrosis of skin | Collagen injection can be used to improve contour deformity from scarring |
L98.9 | Disorder of skin and subcutaneous tissue, unspecified | General code when a more specific diagnosis is not documented but augmentation is clinically indicated |
M79.89 | Other soft tissue disorders, not elsewhere classified | Used for soft tissue contour defects or atrophy treated with filler injections |
Q79.8 | Other congenital malformations of musculoskeletal system | Relevant for congenital soft tissue deficits requiring augmentation |
S40.811A | Contusion of right shoulder, initial encounter | Post-traumatic contour defects after injury may be treated with collagen injections |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11951 | The provider injects 1.1 cc to 5.0 cc of collagen into the subcutaneous layer of skin | Used when a smaller volume of collagen is injected; select 11951 if volume is within this range instead of 11952 |
11954 | The provider injects greater than 10.0 cc of collagen into the subcutaneous layer of skin | Used when the injected volume exceeds 10.0 cc; select 11954 if volume surpasses the upper limit of 11952 |
12001 | Simple repair of superficial wounds (face, ears, eyelids, nose, lips) — typically 2.5 cm or less | May be performed before or after augmentation when minor wound repair is required in the same treatment area |
13101 | Complex repair of wounds, superficial; 2.6 cm to 7.5 cm | Relevant when tissue rearrangement or more extensive repair accompanies augmentation |
96999 | Unlisted procedure, dermatology | Used rarely when a unique or unlisted adjunct procedure related to soft tissue augmentation is performed and no specific CPT code applies |