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2025 CPT code 41826

Excision of a lesion or tumor from dentoalveolar structures with simple repair.

Consult the official CPT coding manual for the most up-to-date guidelines.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT guidelines and local payer policies.

Medical necessity is established by the presence of a lesion or tumor that requires surgical removal for diagnostic or therapeutic purposes. The medical necessity may be driven by symptoms, cosmetic concerns, or the potential for malignancy. Documentation should justify the need for the procedure.

The oral and maxillofacial surgeon or dentist performs the excision, hemostasis, and simple repair.This involves local or general anesthesia, incision, removal of the lesion or tumor, and closure with sutures.

IMPORTANT Use 41825 for excision without repair; use 41827 for excision with complex repair.

In simple words: The doctor removes a growth or tumor from the area around your teeth and gums, then stitches the area closed.

This procedure involves the surgical removal of a lesion or tumor (excluding those specifically listed elsewhere) located within the dentoalveolar structures (teeth and their supporting tissues and bone).Following excision, a simple repair is performed to close the surgical site. This typically includes basic suturing techniques.

Example 1: A patient presents with a suspicious lesion on the gingiva.The surgeon excises the lesion and performs a simple closure., A patient has a small, benign tumor on the alveolar bone.The surgeon removes the tumor and closes the incision with sutures., A patient has a periapical lesion that requires surgical removal. The surgeon removes the lesion and performs a simple repair.

Preoperative and postoperative clinical notes,pathology report (if applicable), operative report detailing the lesion's location, size, and nature, type of repair performed, and any complications.

** Coverage for this procedure may vary based on payer policies and the indication for surgery.Some payers may not cover procedures performed solely for cosmetic reasons. Always verify payer-specific guidelines before billing.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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