CPT 11440Surgery

Exc face-mm b9+marg 0.5 cm/<

CPT 11440 covers the surgical removal of a benign (non-cancerous) growth on the face, ears, eyelids, nose, lips, or mucous membranes, where the lesion is 0.5 cm or smaller and includes a small margin of normal tissue around it.

Showing rates for

National Average

Base Medicare rate

$138.12

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.05

PE RVU (NF)

3.1

MP RVU

0.12

Total RVU

4.27

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Measure and document the excised diameter (lesion PLUS margins) not just the lesion size alone
Impact: Incorrect measurement is the #1 reason for downcoding; accurate measurement documentation prevents $30-50 loss per procedure when downcoded to adjacent code
Specify exact anatomic location within the face/ear/eyelid/nose/lip area in the operative note
Impact: Vague location documentation triggers audits and can result in code denial or request for refund; prevents 100% claim denial ($138.12 loss)
Bill in non-facility settings when appropriate to capture the $32.67 differential between non-facility ($138.12) and facility ($105.45) rates
Impact: Performing in-office instead of hospital outpatient increases practice revenue by 31% per procedure
For multiple lesions, bill each excision separately with appropriate modifiers (59, LT/RT) rather than selecting a higher size code
Impact: Two separate 11440 codes with modifier 59 yields approximately $207 vs incorrectly upcoding to 11441 which may be denied
Confirm pathology report documents benign nature before final claim submission; if malignant, recode to 11640-11646 series
Impact: Using benign code for malignant lesion results in undercoding and lost revenue of $100-300+ depending on actual pathology
Include closure type in documentation; simple closure is included, but intermediate/complex closures may warrant separate coding
Impact: Missing intermediate closure codes (12051-12057) can result in $150-400 in lost revenue per procedure

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 11440 in 2025?

The 2025 Medicare national average payment is $138.12 for non-facility (office) settings and $105.45 for facility settings. The code has a work RVU of 1.05 and total RVU of 4.27 based on the CMS Physician Fee Schedule.

How do I measure the lesion size correctly for CPT 11440?

Measure the total excised diameter including both the lesion AND the margins in centimeters. For 11440, the total excised diameter must be 0.5 cm or less. Use a ruler to measure, not visual estimation, and document the exact measurement in your operative note.

Can I bill CPT 11440 for multiple lesions on the same day?

Yes, you can bill 11440 multiple times for separate lesions excised during the same session. Use modifier 59 to indicate distinct procedural services and specify different anatomic locations. The second and subsequent procedures will typically be reduced by 50% under multiple procedure rules.

What is the difference between CPT 11440 and 11441?

The difference is the excised diameter size. CPT 11440 is for lesions with total excised diameter of 0.5 cm or less, while 11441 covers 0.6 cm to 1.0 cm. Accurate measurement documentation is critical as this determines which code to use and affects reimbursement.

Does CPT 11440 include the pathology exam?

No, CPT 11440 covers only the surgical excision and simple closure. Pathology examination is billed separately using CPT 88305 (tissue exam by pathologist) or other appropriate pathology codes. The pathology service is typically billed by the pathology laboratory.

Can I bill an E/M code on the same day as CPT 11440?

Yes, but only if you perform a significant, separately identifiable evaluation and management service beyond the usual pre-operative assessment. You must append modifier 25 to the E/M code and document the separate medical necessity and decision-making for the E/M service in your note.

What diagnosis codes are typically used with CPT 11440?

Common ICD-10 codes include D22.39 (benign neoplasm of face), L82.1 (seborrheic keratosis), D23.39 (benign neoplasm of skin of face), and L91.8 (other hypertrophic skin disorders). The specific diagnosis must match the pathology findings and clinical presentation to establish medical necessity.