CPT 11444Surgery

Exc face-mm b9+marg 3.1-4 cm

CPT code 11444 is used when a surgeon removes a non-cancerous (benign) skin lesion from the face, including a margin of healthy tissue around it, where the total excised area measures 3.1 to 4.0 centimeters at its widest point.

Showing rates for

National Average

Base Medicare rate

$277.21

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

3.19

PE RVU (NF)

4.9

MP RVU

0.48

Total RVU

8.57

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

NCCI bundling edits

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Billing tips

Measure excised diameter correctly: add lesion size PLUS margins on all sides before excision, not post-excision specimen size which may contract
Impact: Incorrect measurement can result in downcoding to 11443 (2.1-3.0 cm, $222.06 non-facility), a $55.15 loss per procedure
Document anatomic location precisely as 'face' area; facial codes (11440-11446) reimburse higher than trunk/extremity codes (11400-11406) due to cosmetic considerations
Impact: Miscoding as 11404 (trunk/extremity 3.1-4.0 cm) results in $208.41 non-facility rate, a $68.80 underpayment
Bill in non-facility setting when possible; the $54.34 differential favors office-based procedures for practice revenue
Impact: Office-based excision generates $277.21 vs $222.87 in hospital outpatient setting, representing 24% higher reimbursement
Do not separately bill for simple closure (12051-12057); it is included in the excision code reimbursement
Impact: Unbundling closure codes triggers NCCI edits and automatic denials; intermediate/complex closures (12051-13153) may be separately billable with documentation
When multiple lesions are excised, bill each separately with appropriate size-based code; do not combine diameters
Impact: Each lesion billed separately maximizes reimbursement; second lesion with modifier 51 still generates $138.61 vs incorrect bundling which may yield $0
Verify pathology confirms benign diagnosis; if malignant findings result, consider corrected claim with malignant excision codes (11644) which reimburse higher
Code 11644 (malignant excision face 3.1-4.0 cm) has Work RVU of 4.67 vs 3.19, potentially yielding higher appropriate reimbursement if pathology supports

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Frequently asked questions

What is the Medicare reimbursement for CPT code 11444 in 2025?

Medicare pays $277.21 for CPT 11444 in non-facility settings (office) and $222.87 in facility settings (hospital outpatient) based on the 2025 Medicare Physician Fee Schedule. These are national averages; actual rates may vary by locality based on geographic practice cost indices (GPCI).

How do you measure lesion size for CPT code 11444?

Measure the greatest clinical diameter of the lesion PLUS the margins required for complete excision BEFORE the procedure. For 11444, this total measurement must be 3.1 to 4.0 cm. Do not use the pathology specimen size, as tissue contracts after excision. Document the pre-excision measurement in your operative note.

What anatomic locations qualify for CPT 11444?

CPT 11444 applies to excisions on the face, ears, eyelids, nose, lips, and mucous membranes. This includes the forehead, cheeks, chin, periorbital area, and scalp. Neck, trunk, arms, legs, hands, and feet use different code series (11400-11406 for benign lesions) with lower reimbursement.

Can I bill CPT 11444 with a closure code?

Simple closure is included in CPT 11444 and cannot be billed separately. However, if you perform intermediate (12051-12057) or complex closure (13151-13153) requiring layered closure of subcutaneous tissue and dermis, you may bill these separately with appropriate documentation and possibly modifier 59 to indicate a distinct procedural service.

What is the difference between CPT 11444 and 11443?

The only difference is excised diameter size: CPT 11443 covers 2.1 to 3.0 cm ($222.06 non-facility, Work RVU 2.63), while 11444 covers 3.1 to 4.0 cm ($277.21 non-facility, Work RVU 3.19). The anatomic location (face) and benign nature are the same. Accurate pre-excision measurement determines the correct code.

Does CPT 11444 require pathology confirmation?

Yes, specimens should be submitted to pathology to confirm the benign diagnosis and support medical necessity. If pathology returns malignant findings (basal cell carcinoma, squamous cell carcinoma, melanoma), you may need to submit a corrected claim using malignant excision codes (11644 for 3.1-4.0 cm malignant facial lesion) which have different reimbursement rates.

How many times can CPT 11444 be billed in one session?

You can bill CPT 11444 multiple times in one session if multiple separate lesions meeting size criteria are excised. Each lesion should be measured and documented separately. Use modifier 51 on the second and subsequent procedures; the second procedure typically reimburses at 50% ($138.61 for Medicare non-facility). Do not combine the diameters of multiple lesions.