4075F CPT Performance Measure Benchmarks & Policy | OpenPayer

Summary & Overview

CPT 4075F: Category II Performance Measure Code

CPT code 4075F is a Category II performance measure code used to report a specific clinical quality or performance metric. Category II codes are intended to support performance measurement and capture structured data about patient care processes, clinical outcomes, or adherence to recommended practices. Although Category II codes do not represent billable services in the same way as primary CPT procedure codes, they matter nationally because they enable standardized reporting for quality programs, payer performance tracking, and value-based care initiatives.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, how Category II codes function within clinical reporting, and the national relevance for quality measurement and payer reporting. The content highlights the role of such codes in benchmarking, payer quality programs, and clinical documentation workflows.

Where input data is missing, the publication notes that specific descriptive detail, service type, and typical site of service are not available in the input. The reader will learn the purpose of Category II codes, the kinds of insights they provide for payers and providers, and which areas require additional data to support operational implementation and reporting.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare4075FCPTCategory IIperformance-measurequality-reportingvalue-based-careclinical-documentation

Billing Code Overview

CPT code 4075F is listed without a descriptive summary in the source data. Based on the code label format, this is a CPT Category II performance measure code used for reporting a specific clinical performance or quality metric. The code represents a structured quality or performance data element rather than a billable procedure or service.

Service Type: Data not available in the input.

Typical Site of Service: Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting to an outpatient otolaryngology or oral and maxillofacial surgery clinic with functional or aesthetic concerns related to the nasal tip, nostrils, or perinasal soft tissues. Evaluation includes history, physical examination, and photographic documentation. Indications for the procedure associated with 4075F commonly include repair or reconstruction of nasal soft tissue defects following trauma, excision of benign skin lesions, or correction of postoperative complications from prior nasal surgery. The clinical workflow generally involves preoperative assessment, informed consent, local or general anesthesia in an ambulatory surgery center or hospital outpatient department, performance of soft tissue repair or reconstruction using local flaps or grafts, hemostasis and dressing application, and brief postoperative monitoring with discharge instructions and scheduled follow-up for wound checks and suture removal. Typical site of service is an outpatient surgical suite, ambulatory surgery center, or hospital outpatient department.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service on the same day	Use when a distinct E/M visit is documented on the day of the procedure.

Related Codes

CPT-4558F-UNSPECIFIED-SERVICE

CPT 4558F: Unspecified Clinical Service

CPT-4540F-SPECIFIC-CLINICAL-MEASURE

CPT 4540F: Specific Clinical Measure

CPT-4149F-HEPATITIS-B-VACCINATION-STATUS-IN-HEPATITIS-C-ADULT

CPT 4149F: Hepatitis B Vaccination Status for Adults with Hepatitis C

CPT-4256F-SHORT-DURATION-ANESTHESIA-LESS-THAN-1-HOUR

CPT 4256F: Anesthesia for Less Than One Hour

CPT-4060F-NO-SUMMARY-AVAILABLE

CPT 4060F: No Summary Available

CPT-4153F-NO-SUMMARY-AVAILABLE

CPT 4153F: Unspecified CPT Measure or Service

CPT-4168F-NO-SUMMARY-AVAILABLE

CPT 4168F: No Summary Available

CPT-4131F-NO-SUMMARY-AVAILABLE

CPT 4131F: No Summary Available

CPT-4552F-UNSPECIFIED-CPT-4552F

CPT 4552F: Unspecified CPT Code

CPT-4550F-QUALITY-MEASURE-PERFORMANCE-REPORTING

CPT 4550F: Quality Measure Performance Reporting

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Taxonomy Code	Specialty	Notes
207Q00000X	Otolaryngology	Common specialty performing nasal soft-tissue repairs and reconstructions.
207K00000X	Oral and Maxillofacial Surgery	Performs facial soft tissue and nasal reconstructions, particularly after trauma or tumor resection.
207P00000X	Plastic Surgery	Provides reconstructive and cosmetic nasal tip and nasal soft-tissue procedures.
207L00000X	Dermatology	Performs excision of skin lesions and local soft-tissue repairs of the nose.
208300000X	General Surgery	May be involved for complex nasal or facial soft-tissue reconstruction in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S01.20XA`	Laceration without foreign body of nose, initial encounter	Represents a nasal soft-tissue laceration requiring repair.
`S01.209A`	Laceration of nose, unspecified, initial encounter	General code for nasal laceration presenting for closure.
`D23.2`	Benign neoplasm of skin of other and unspecified parts of face	Indicates excision of benign skin lesion on or near the nose requiring closure.
`C44.31`	Basal cell carcinoma of skin of other and unspecified parts of face	Malignant lesion of the nose requiring excision and subsequent reconstruction.
`T81.89XA`	Other complications of procedures, initial encounter	Used when postoperative complications require return to the procedure room or additional repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12051`	Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm	Often used for layered closure of nasal soft-tissue lacerations or excision sites when more extensive repair is required.
`14040`	Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 10 sq cm or less	Used when local flap reconstruction is performed to repair nasal defects after excision.
`13121`	Repair, complex, trunk or extremity; 1.1 cm to 2.5 cm	Included as an example of complex repair technique codes; for nasal complex repairs, CPT codes in the 12000 or 14000 series are typically selected based on technique and size.
`15732`	Muscle, myocutaneous or fasciocutaneous flap with microvascular anastomosis (includes recipient site preparation and closure)	Used when thicker or regional flap reconstruction is required for large nasal defects (rare in simple nasal soft-tissue procedures).
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Commonly billed for preoperative and postoperative visits associated with the procedure.