Is removing a growth on my face covered by insurance?
It depends on why it is coming off. Code 11440 is a small growth, half a centimeter or less, cut out of the face, ear, eyelid, nose, or lip. Plans pay when the note shows it hurts, bleeds, catches, or looks suspicious. Removal for appearance alone runs into a cosmetic exclusion on most plans.
Depends
Symptoms decide it, not the spot
Cosmetic first
The face is where plans look hardest for cosmetic intent. A note that only says the patient did not like the look gets denied on sight.
Half a centimeter
11440 stops at 0.5 cm measured with margins before the cut. A growth a millimeter wider moves to 11441 and a different fee.
Benign only
If the lab comes back cancerous, the visit moves to a facial skin cancer code such as 11642. Pathology sets the final code, not the consult.
Two bills
The lab reads the tissue and bills separately under 88305. Run the check first so the desk can explain both bills before the patient asks.
What would a real check show for this patient's 11440?
Pick a sample plan and type your fee. This is the visibility a real-time check gives the desk for every actual patient, in under a second.
Eligibility readout · 11440
Sample- Coverage
- Active, $40 copay, referral on file
- Frequency
- Covered when the note shows symptoms
- Patient share
- Type your fee to see it
Estimate from a sample plan. A real check reads the actual plan in under a second.
When 11440 is the right code
- The growth sits on the face, ear, nose, or lip
- Removed full thickness rather than shaved off
- Measured 0.5 cm or less with margins
- The note records pain, bleeding, growth, or irritation
- Pathology confirms the growth is not cancer
Documentation payers expect
Payers want the size in centimeters, the exact location, and the symptom that made removal necessary. A photo in the chart and the pathology report settle most cosmetic disputes before they start.
Why a face removal gets denied
What happens after the removal
The tissue goes to a lab, so a second bill lands weeks later under 88305, often from a company the patient has never heard of. The suture visit about a week later falls inside a ten day global window, so it is recorded as 99024 and carries no fee. If the lab finds cancer, the next step is a wider removal or Mohs, 17311, and the numbers change again. One check up front means the lab bill is not the first surprise.
11440, quick answers
Will my plan pay if I just want it gone?
Usually not. Removal for appearance alone hits a cosmetic exclusion on most plans, and the patient pays the full fee, which the office should quote up front.
Does Medicare cover 11440?
Medicare pays to remove a benign growth only when the record shows a real problem such as bleeding, pain, or interference, or when the spot is suspicious enough to need a diagnosis. Removal purely for looks is not covered, and the office may ask the patient to sign an ABN first.
Why does the size matter so much?
Both the code and the fee follow the size. 11440 stops at 0.5 cm, so a slightly wider growth lands on the next code up.
Is the lab bill part of this charge?
No. Reading the tissue is billed separately, usually under 88305, and it can come from an outside lab with its own network status.
What if the growth turns out to be cancer?
Then the visit is coded as a facial skin cancer excision, often 11642, and coverage generally follows as medically necessary. Benefits are worth rechecking before the next step goes on the schedule.
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Related: 11310 · 11402 · 11642
CPT is a registered trademark of the American Medical Association. This page is Valian's own plain-English summary for front-desk teams, not official CPT descriptor text, and is not billing or clinical advice. Coverage patterns are common plan behaviors; every plan differs. Verify benefits before the visit.