2025 CPT code 11954

Subcutaneous injection of filling material (e.g., collagen); over 10.0 cc

Follow all relevant CPT coding guidelines.Accurate documentation is crucial for proper reimbursement.

Modifiers may be applicable depending on the circumstances.Consult the CPT manual for appropriate modifier usage.

The medical necessity for this procedure is primarily cosmetic.Documentation should clearly outline the patient's desire for improvement in their appearance related to contour defects.

The physician injects the filler material into the subcutaneous layer of the skin to correct contour defects.

IMPORTANT 11950 (1 cc or less), 11951 (1.1 to 5.0 cc), 11952 (5.1 to 10 cc)

In simple words: This code describes a procedure where a doctor injects more than 10 cubic centimeters (cc) of a substance like collagen under the skin to fill in wrinkles or scars and improve the skin's appearance.

This CPT code encompasses the subcutaneous injection of a filling material, such as collagen, exceeding 10.0 cc.The procedure involves injecting the filler into the subcutaneous layer of the skin to fill depressions caused by scars or wrinkles. The injected material is used to improve the cosmetic appearance of the skin by restoring volume and smoothing irregularities.

Example 1: A patient presents with deep acne scars on their cheeks. The physician injects over 10 cc of collagen to fill the depressions, improving the skin's contour and appearance., A patient desires to reduce the appearance of deep wrinkles around their mouth. The physician performs a series of injections totaling over 10 cc of a hyaluronic acid-based filler to achieve the desired cosmetic result., A patient has significant volume loss in their cheeks due to aging.The physician uses over 10 cc of a combination of fillers to restore volume and enhance facial contour.

* Detailed patient history including the reason for the procedure and the patient's expectations.* Photographs documenting the pre-procedure and post-procedure appearance.* Precise measurements of the injected filler material.* Documentation of the specific type and amount of filler used.* Note on any complications or adverse events.* Informed consent documentation.

** This procedure may be performed in conjunction with other cosmetic procedures.Accurate documentation of the type and amount of filler used is essential for billing and reimbursement.

  • Revenue Code: P6A (Minor Procedures - Skin)
  • RVU: Consult the Medicare Physician Fee Schedule (MPFS) for reimbursement rates and guidelines.
  • Global Days : Unknown
  • Payment Status: Active
  • Modifier TC rule: Unknown
  • Fee Schedule : Consult the MPFS for historical fee schedule data.
  • Specialties:Dermatology, Plastic Surgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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