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    v1.0.30
    OpenPayerBilling CodesRepair Procedures on the LipsCPT cpt-40700-unilateral-cleft-lip-repair-nasal-deformity
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    CPT 40700: Repair of Unilateral Cleft Lip

    Medicare pays $929 on average nationally for this procedure.

    CPT code 40700 describes the surgical repair of a partial or complete cleft lip defect or associated nasal deformity for a unilateral procedure; this is a reconstructive surgical service typically performed by a plastic or craniofacial surgeon in an operating room or ambulatory surgical center and involves tissue repair and reshaping to restore lip and nasal form and function.

    For related coverage guidance, see recent payer policy updates: Destruction of Pre-Malignant Skin Lesions, Onychomycosis diagnostic testing and coverage, Treatment of Capillary Malformations (Port Wine Stains).

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    Clinical & Coding Specifications

    Clinical Context

    A full-term infant is evaluated by a pediatrician at a newborn nursery exam and found to have a unilateral complete cleft lip extending into the nasal sill. The patient is referred to a pediatric plastic surgeon and a multidisciplinary craniofacial team. Preoperative assessment includes feeding evaluation, growth and airway review, and anesthesia clearance. The surgeon schedules a primary unilateral cleft lip repair under general anesthesia in an ambulatory surgery center or pediatric hospital operating room when the infant reaches an appropriate age and weight (commonly about 3 months), following local institutional timing protocols. The procedure includes surgical closure of the lip defect, anatomic muscle repair, and nasal cartilage repositioning to restore form and function. Postoperative care includes short inpatient or same-day observation, wound care instructions, pain management, feeding support, and follow-up with the craniofacial team for potential staged nasal or orthodontic interventions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    41899Unlisted procedure, lipUsed when a specific lip repair technique or an uncommon variation is not adequately described by available codes and requires unlisted reporting
    30465Repair of nasal tip, complicated (e.g., repositioning of lower lateral cartilages)Performed when additional nasal reconstruction beyond standard cleft nasal correction is required during or after unilateral cleft lip repair
    40720Secondary repair of cleft lip and/or nasal deformity (revision)Used for revision procedures addressing residual deformity after the primary unilateral cleft lip repair
    21121Repair of nasal septum, complex; open approachUsed when significant septal work is required to improve nasal airway or support nasal reconstruction in conjunction with cleft repair
    70450CT head or facial bones without contrastImaging that may be obtained preoperatively for complex craniofacial planning in select cases

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    2080P0206X
    207L00000X
    2084P0800X
    363A00000X
    207RE0101X
    111NN0400X
    133VN1201X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    J34.89Other specified disorders of nose and nasal sinuses
    Q16.0Congenital absence of (ear) auricle
    Q16.1Congenital absence, atresia and stricture of auditory canal (external)
    Q16.2Absence of eustachian tube
    Q16.3Congenital malformation of ear ossicles
    Q18.0Sinus, fistula and cyst of branchial cleft
    Q18.1Preauricular sinus and cyst
    Q18.2Other branchial cleft malformations
    Q18.3Webbing of neck
    Q18.8Other specified congenital malformations of face and neck

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01
    Topical Acne-Non-Retinoid ProductsCigna2026-08-15
    Dermatology - Vtama Drug Quantity Management Policy - Per DaysCigna2026-08-15
    Medical Necessity Guidelines: Acne and Rosacea Medicationsharvard pilgrim health care2026-08-11
    Dermatology - Anzupgo Prior Authorization PolicyCigna2026-08-05
    Light Therapy for Dermatologic Conditionsbcbsvermont2026-08-01

    Related Codes

    CPT-40650-LIP-VERMILION-FULL-THICKNESS-REPAIR

    CPT 40650: Repair of Full-Thickness Vermilion (Lip) Tear

    CPT-40652-LIP-LACERATION-FULL-THICKNESS-CLOSURE-UP-TO-HALF-HEIGHT

    CPT 40652: Lip Full‑Thickness Tear Closure (≤ half vertical height)

    CPT-40654-LIP-FULL-THICKNESS-TEAR-CLOSURE

    CPT 40654: Closure of Full-Thickness Lip Tear (>50% Vertical Height)

    CPT-40701-CLEFT-LIP-AND-NASAL-DEFORMITY-REPAIR-BILATERAL

    CPT 40701: Cleft Lip and Nasal Deformity Repair, Bilateral

    CPT-40702-BILATERAL-CLEFT-LIP-NASAL-REPAIR-TWO-STAGE

    CPT 40702: Bilateral Cleft Lip Repair, One Stage

    CPT-40720-SECONDARY-CLEFT-LIP-NASAL-REPAIR

    CPT 40720: Secondary Repair of Cleft Lip and Nasal Deformity

    CPT-40761-ABBE-ESTLANDER-PEDICLE-FLAP-REPAIR-CLEFT-LIP-NASAL-DEFORMITY

    CPT 40761: Abbe-Estlander Pedicle Flap for Cleft Lip Repair

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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