Summary & Overview
CPT 14301: Local Tissue Replacement for 30.1–60.0 cm2 Defect
CPT code 14301 denotes a local tissue replacement procedure for defects sized 30.1 cm2 to 60.0 cm2, used when lesions are excised and adjacent healthy tissue is mobilized to close the defect. This reconstructive technique is clinically significant across specialties including plastic surgery, dermatologic surgery, and surgical oncology because it balances defect closure with tissue preservation and functional outcomes. Nationally, utilization of such flap and local advancement procedures is relevant for hospital surgical planning, ambulatory surgical center workflows, and payer coverage policies.
Key payers included in the discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will encounter a concise overview of the code’s clinical intent and service profile, typical sites of service, and the payer landscape relevant to reimbursement and claim adjudication. The publication also provides benchmarks for utilization, notes on documentation elements that commonly influence coverage decisions, and contextual clinical considerations for defect size and technique selection. Where input data is missing, the text notes availability limitations. The summary is intended for revenue cycle leaders, surgical providers, and policy analysts seeking a national perspective on coding, clinical context, and payer coverage patterns for CPT code 14301.
Billing Code Overview
CPT code 14301 describes a surgical procedure in which the provider replaces lesions in any area with healthy tissue taken from an adjacent site. This code represents repair of a defect measuring 30.1 cm2 to 60.0 cm2.
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Service type: Surgical soft tissue reconstruction using local tissue transfer (flap or local advancement)
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Typical site of service: Hospital operating room or outpatient surgical center where reconstructive soft-tissue procedures are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents to an outpatient surgical clinic after excision of a basal cell carcinoma on the left cheek. The surgical defect measures approximately 45 cm2 after wide local excision. The reconstructive surgeon plans a local tissue rearrangement with adjacent tissue transfer (local flap) to replace the cutaneous defect and restore contour and function. The procedure is scheduled in an ambulatory surgery center under monitored anesthesia care. Preoperative documentation includes lesion size mapping, photographic localization, informed consent for local flap reconstruction, assessment of vascular supply to the adjacent donor tissue, and plan for layered closure. Intraoperative workflow includes lesion re-excision margins as needed, defect measurement confirming an area between 30.1 cm2 and 60.0 cm2, design and elevation of the local flap from contiguous tissue, transfer and inset of the flap into the defect, hemostasis, layered closure, and placement of dressings. Postoperative documentation includes flap viability assessment, instructions for wound care, and planned follow-up for suture removal and monitoring for complications such as partial flap necrosis or infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work, time, or complexity is substantially greater than typical for the procedure (document justification). |
50 | Bilateral procedure | Use when the same procedure is performed on both sides of the body during the same operative session. |
51 | Multiple procedures | Use when multiple different surgical procedures are performed at the same session; CIN/packaging rules apply. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned (document reason). |
59 | Distinct procedural service | Use to indicate a separate, distinct procedure not normally reported together; support with operative note. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |
76 | Repeat procedure by same physician | Use when the same physician repeats the procedure later the same day. |
78 | Unplanned return to the operating room | Use when the patient returns to the OR for a related procedure during the global period. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period. |
26 | Professional component | Use when reporting only the professional component of a service that has a technical component. |
TC | Technical component | Use when reporting only the technical component of a service. |
LT | Left side | Use to indicate procedure performed on the left side of the body. |
RT | Right side | Use to indicate procedure performed on the right side of the body. |
ET | Exempt from hospital outpatient prospective payment system (OPPS) packaging | Use when services are exempt from OPPS packaging rules per payer policy. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Plastic Surgery | Common specialty performing local flap reconstruction for cutaneous defects. |
| 207N00000X | Otolaryngology (ENT) | Performs facial soft tissue reconstruction, particularly for head and neck defects. |
| 208100000X | Dermatology | Mohs surgeons or dermatologic surgeons commonly perform excision and immediate reconstruction. |
| 208800000X | General Surgery | May perform soft tissue reconstruction for non-cosmetic defects on the trunk or extremities. |
| 207K00000X | Oral and Maxillofacial Surgery | Performs facial soft tissue reconstruction for defects involving perioral and perimandibular regions. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.311 | Basal cell carcinoma of right upper eyelid, including canthus | Facial skin cancers such as basal cell carcinoma commonly require excision and local flap reconstruction for defects in the head and neck. |
C44.312 | Basal cell carcinoma of left upper eyelid, including canthus | Same as above; laterality guides LT/RT modifiers and operative planning. |
C44.319 | Basal cell carcinoma of eyelid, unspecified | Used when specific anatomic subsite is not otherwise specified prior to final pathology. |
C44.91 | Malignant neoplasm of skin, unspecified | General code for skin malignancy when site-specific code is not available; drives need for excision and reconstruction. |
S81.811A | Open wound of right lower leg, initial encounter | Traumatic soft-tissue defects may require adjacent tissue transfer when primary closure is not feasible. |
T81.89XA | Other complication of surgical and medical care, initial encounter | Used for postoperative complications requiring return to OR or further reconstruction; relevant for global period management. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
14040 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm | May be used for smaller adjacent tissue transfers when defect size is below the 14301 range; useful when multiple staged closures are planned. |
14302 | Adjacent tissue transfer or rearrangement, any area; defect 60.1 sq cm to 120.0 sq cm | Used when defect area exceeds the 14301 upper limit; choose based on final measured defect size. |
17311 | Mohs micrographic technique, first stage, with frozen sections and microscopic examination of margins; head, neck, hands, feet, genitalia; excision plus margins and repair | Performed prior to reconstruction when Mohs surgery is used for oncologic clearance; reconstruction with 14301 may follow Mohs stages. |
13131 | Secondary closure of surgical wound; complex including undermining, extensive mobilization (per facial site rules) | May be used for complex layered closure techniques or when primary closure differs from adjacent tissue transfer coding. |
12032 | Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm | Smaller wound repair codes may be billed for additional discrete repairs performed at the same operative session in other anatomic sites. |