Summary & Overview
CPT 14041: Adjacent Tissue Transfer (Local Flap) for 10.1–30.0 cm² Defect
CPT code 14041 covers adjacent tissue transfer (local flap) procedures used to repair defects measuring 10.1 cm² to 30.0 cm² on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, or feet. This reconstructive surgery code is nationally relevant because it standardizes reporting for soft-tissue repairs of moderate size and supports clinical and payment consistency across surgical and outpatient settings. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 14041 is appropriate, typical sites of service where the procedure is performed, and the common modifiers associated with billing for reconstructive flaps. The publication outlines benchmark information and payer coverage considerations where available, highlights documentation elements that commonly affect adjudication, and summarizes how this code relates to other reconstructive procedure codes. Data not available in the input is indicated where applicable. This summary is intended for a national audience of providers, billing professionals, and policy analysts seeking a practical reference for clinical coding and payer communication regarding moderate-size local flap reconstructions.
Billing Code Overview
CPT code 14041 describes a surgical procedure in which the provider replaces lesions on the forehead, cheeks, chin, mouth, neck, axillae (armpits), genitalia, hands, or feet with healthy tissue taken from an adjacent site. This code applies to a defect size of 10.1 cm² to 30.0 cm².
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Service type: Adjacent tissue transfer (local flap) for soft tissue reconstruction
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Typical site of service: Hospital outpatient department, ambulatory surgical center, or inpatient operating room depending on clinical complexity and payer requirements
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents to an outpatient surgical clinic with a 12.5 cm2 full-thickness skin defect on the left cheek after Mohs micrographic surgery for an invasive cutaneous squamous cell carcinoma. The defect involves the cheek and extends toward the nasolabial fold, requiring local tissue rearrangement. Under monitored anesthesia care in an ambulatory surgery center, the dermatologic surgeon performs a local tissue flap reconstruction using adjacent cheek tissue to replace the defect. Hemostasis is achieved, the flap is inset with layered closure, and a sterile dressing is applied. The typical workflow includes preoperative evaluation and consent, lesion excision by Mohs or surgical oncology, immediate intraoperative assessment of defect size (confirming 10.1–30.0 cm2), selection and elevation of the appropriate local flap (advancement, transposition, or rotation), layered closure, and post-anesthesia recovery with discharge instructions and wound care follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when services are substantially greater than typical for local flap reconstruction due to complexity or extensive tissue manipulation. |
24 | Unrelated evaluation and management service by the same physician during a postoperative period | Use when an unrelated E/M visit occurs during the global period. |
25 | Significant, separately identifiable E/M service on the same day | Use when a distinct E/M visit is performed the same day as the surgery. |
50 | Bilateral procedure | Use when an identical flap procedure is performed on both sides of a paired anatomic site. |
51 | Multiple procedures | Use when additional distinct procedures are performed during the same operative session. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances. |
59 | Distinct procedural service | Use to indicate a procedure or service that was distinct or independent from other services performed on the same day. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct surgical components. |
76 | Repeat procedure by same physician | Use when the procedure is repeated by the same physician during the postoperative period. |
77 | Repeat procedure by another physician | Use when a subsequent physician repeats the procedure during the postoperative period. |
78 | Return to the operating room for a related procedure during the postoperative period | Use when a return to OR is required for related complications or revisions. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when a different unrelated procedure is performed during the global period. |
LT | Left side | Use to identify laterality when the procedure is performed on the left anatomic site. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207N00000X | Dermatology | Dermatologic surgeons and Mohs surgeons commonly perform lesion excision and local flap reconstruction. |
| 208100000X | Plastic Surgery | Plastic and reconstructive surgeons perform local flap reconstructions for facial and other complex defects. |
| 2080P0207X | Facial Plastic Surgery | Specialists in facial reconstruction for aesthetic and functional restoration of facial defects. |
| 207L00000X | General Surgery | General surgeons may perform local flap procedures in non-facial sites such as trunk or extremities. |
| 208000000X | Otolaryngology | Head and neck surgeons perform flap reconstructions for defects in perioral, perinasal, and neck regions. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.311 | Squamous cell carcinoma of skin of left cheek | Common malignant lesion whose surgical excision creates full-thickness defects requiring local flap reconstruction. |
C44.319 | Squamous cell carcinoma of skin of unspecified cheek | Used when side is not documented; excision may necessitate flap coverage. |
C44.511 | Basal cell carcinoma of skin of left eyelid, including canthus | Periocular resections can produce defects addressed with local flaps. |
D23.5 | Other benign neoplasm of skin of face | Large benign lesions or excisions for symptomatic lesions may produce defects requiring reconstruction. |
S01.411A | Laceration without foreign body of left cheek, initial encounter | Traumatic defects and lacerations of this size may be repaired with local flap tissue transfer. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11646 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 30.0 mm | Performed prior to reconstruction for excision of cutaneous malignancy that generated the defect requiring flap repair. |
12051 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm | May be used for smaller layered closures when primary closure is feasible instead of flap reconstruction. |
13102 | Complex repair, forehead, cheeks, chin, mouth, neck, axillae; 2.6 cm to 7.5 cm | Used for complex layered closures and may be chosen when the defect can be closed without flap transfer. |
15734 | Muscle, myocutaneous, or fasciocutaneous flap; trunk | Used when larger or deeper defects require regional or distant flap coverage beyond local tissue rearrangement. |
12052 | Intermediate repair, face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm | Used for intermediate layered closures when less complex repair is appropriate. |