CPT 11441Surgery

Exc face-mm b9+marg 0.6-1 cm

CPT 11441 covers the surgical removal of a benign (non-cancerous) growth from the face, including a safety margin, when the total excised area measures between 0.6 and 1.0 centimeters.

Showing rates for

National Average

Base Medicare rate

$168.20

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

1.53

PE RVU (NF)

3.49

MP RVU

0.18

Total RVU

5.2

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

NCCI bundling edits

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Billing tips

Measure the excised diameter (lesion plus margins) after excision, not the lesion alone—this is the dimension that determines code selection and is a frequent source of undercoding
Impact: Properly measuring could justify 11442 instead of 11441, increasing reimbursement from $168.20 to approximately $220+ if excised diameter exceeds 1.0 cm
Verify anatomic location qualifies as face/mucous membrane (face, ears, eyelids, nose, lips, mucous membrane)—neck and scalp use different, lower-paying code series (11420-11426)
Impact: Miscoding facial lesions as trunk/extremity codes (11400-11406) reduces payment by approximately $50-80 per procedure
Code each separately excised lesion individually—multiple lesions in the same session should be listed with modifier 51 on second and subsequent procedures, arranged by RVU value descending
Impact: Proper sequencing maximizes reimbursement; first procedure pays $168.20, additional procedures pay approximately $84.10 each
Document medical necessity clearly when excising benign lesions—cosmetic procedures may not be covered; note symptoms like bleeding, irritation, rapid growth, or patient concern after clinical examination
Impact: Lack of medical necessity documentation is the leading cause of denial; proper documentation prevents $168.20 write-offs
Bill facility vs non-facility correctly based on site of service—office setting uses non-facility rate ($168.20), hospital outpatient or ASC uses facility rate ($130.68)
Impact: Incorrect site of service coding can result in claim rejection or $37.52 payment difference requiring correction
Do not separately bill for closure—simple closure is bundled into excision codes; only intermediate (12051-12057) or complex closure (13151-13153) can be billed separately with appropriate documentation

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 11441 in 2025?

The 2025 Medicare national average payment for CPT 11441 is $168.20 in the non-facility (office) setting and $130.68 in the facility setting (hospital outpatient or ASC). Actual payment may vary based on geographic locality adjustments.

How do you measure the lesion size for CPT 11441?

CPT 11441 requires measurement of the excised diameter (lesion plus margins) of 0.6 to 1.0 cm, measured after excision is complete. Measure the greatest clinical diameter of the removed tissue, not just the visible lesion before excision. Documentation should state this measurement in centimeters in the operative note.

What body locations qualify for CPT 11441?

CPT 11441 applies only to excisions on the face, ears, eyelids, nose, lips, and mucous membranes. The neck, scalp, trunk, arms, and legs require different CPT codes (11420-11426 for scalp/neck/extremities, 11400-11406 for trunk). Location must be clearly documented to support code selection.

Can you bill CPT 11441 for multiple lesions on the same day?

Yes, each separately excised lesion should be coded individually. List the highest RVU procedure first, then add modifier 51 to subsequent procedures. The first excision pays 100% ($168.20), and additional excisions typically pay at 50% ($84.10 each for Medicare).

Is closure included in CPT 11441 or billed separately?

Simple closure (single layer) is included in CPT 11441 and cannot be billed separately. Only intermediate closure (layered closure, 12051-12057) or complex closure (13151-13153) involving significant undermining or extensive repair can be coded separately with appropriate documentation.

What is the difference between CPT 11441 and 11442?

The difference is the excised diameter: CPT 11441 is for 0.6-1.0 cm excised diameter, while 11442 is for 1.1-2.0 cm. The measurement includes margins, not just the lesion. CPT 11442 has higher RVUs and reimbursement (approximately $220+ vs $168.20), making accurate measurement critical.

Does CPT 11441 require pathology to be performed?

While pathology is typically performed and considered standard of care for excised lesions, CPT 11441 does not require pathology for billing purposes. However, pathology (88305) must be coded separately when performed. The pathology report can also validate the excised specimen size documented by the surgeon.