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CPT 11960: Tissue Expander Placement for Non‑Breast Reconstruction
CPT code 11960 covers the surgical placement of tissue expanders under the skin to facilitate reconstruction of soft-tissue defects outside the breast. The procedure enables staged tissue expansion to restore contour and cover defects resulting from trauma, oncologic resection, or congenital anomalies. Nationally, this code is important for reconstructive and plastic surgery billing and impacts hospital and ambulatory surgery center workflows, supply use, and perioperative care pathways.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the procedure and typical sites of service, common payer coverage patterns, and the scope of clinical contexts in which the code is used. The publication provides benchmarks and utilization context where available, notes common modifiers associated with surgical implant procedures, and outlines coding considerations relevant to reconstruction outside the breast.
This summary is intended for billing managers, surgical practices, and policy analysts seeking a national overview of CPT code 11960, including clinical intent, payer scope, and items to consider when documenting and submitting claims. Data not available in the input is clearly noted in relevant sections of the full publication.
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Billing Code Overview
CPT code 11960 describes the surgical placement of one or more tissue expanders under the patient’s skin to expand soft tissues for reconstruction of tissue defects. This code applies to placement of expanders anywhere in the patient’s body except the breast.
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Service type: Surgical implant procedure for tissue expansion and reconstruction
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Typical site of service: Ambulatory surgical center or hospital outpatient/inpatient surgical setting depending on clinical complexity and patient needs