Plastic Surgery CPT Codes in the ASC Setting
Plastic surgery is a high-volume specialty in ambulatory surgery centers. Many reconstructive and skin procedures are short, scheduled, and outpatient, which makes them a natural fit for the ASC setting.
Most ASC plastic surgery work falls in the integumentary CPT family, roughly the 11000 to 19499 range, covering debridement, grafts, flaps, repairs, and breast procedures. Our dataset maps 405 ASC-relevant codes to this specialty. Examples include 19318 (breast reduction) and 11042 (subcutaneous tissue debridement, first 20 sq cm or less). Whether Medicare pays for a code in an ASC depends on the CMS addenda: Addendum AA codes are on the ASC Covered Procedures List, meaning Medicare pays them in an ASC, while Addendum EE codes are excluded. DataLily's procedure library tracks CPT-specific prior-authorization and documentation requirements for these codes.
Plastic Surgery codes(1–60 of 405)
- 19318Breast reduction
- 15734Muscle-skin graft trunk
- 15823Blepharp upr eyelid xcsv skn
- 11042Dbrdmt subq tis 1st 20sqcm/<
- 11000Dbrdmt ecz/infected skin<10%
- 11001Dbrdmt ecz/infct skn ea addl
- 11004Dbrdmt skin xtrnl gent&per
- 11005Dbrdmt skin abdominal wall
- 11006Dbrdmt skin xtrnl gent per
- 11008Rmv prstc mtrl/mesh abd wall
- 11010Debride skin at fx site
- 11011Debride skin musc at fx site
- 11012Deb skin bone at fx site
- 11043Dbrdmt musc&/fsca 1st 20/<
- 11044Dbrdmt bone 1st 20 sq cm/<
- 11045Dbrdmt subq tiss each addl
- 11046Dbrdmt musc&/fsca ea addl
- 11047Dbrdmt bone each addl
- 11055Paring/cutg b9 hyprker les 1
- 11056Parng/cutg b9 hyprkr les 2-4
- 11057Parng/cutg b9 hyprkr les >4
- 11102Tangntl bx skin single les
- 11103Tangntl bx skin ea sep/addl
- 11104Punch bx skin single lesion
- 11105Punch bx skin ea sep/addl
- 11106Incal bx skn single les
- 11107Incal bx skn ea sep/addl
- 11200Rmvl skin tags up to&inc 15
- 11201Rmvl skin tags ea addl 10
- 11300Shave skin lesion 0.5 cm/<
- 11301Shave skin lesion 0.6-1.0 cm
- 11302Shave skin lesion 1.1-2.0 cm
- 11303Shave skin lesion >2.0 cm
- 11305Shave skin lesion 0.5 cm/<
- 11306Shave skin lesion 0.6-1.0 cm
- 11307Shave skin lesion 1.1-2.0 cm
- 11308Shave skin lesion >2.0 cm
- 11310Shave skin lesion 0.5 cm/<
- 11311Shave skin lesion 0.6-1.0 cm
- 11312Shave skin lesion 1.1-2.0 cm
- 11313Shave skin lesion >2.0 cm
- 11400Exc tr-ext b9+marg 0.5 cm<
- 11401Exc tr-ext b9+marg 0.6-1 cm
- 11402Exc tr-ext b9+marg 1.1-2 cm
- 11403Exc tr-ext b9+marg 2.1-3cm
- 11404Exc tr-ext b9+marg 3.1-4 cm
- 11406Exc tr-ext b9+marg >4.0 cm
- 11420Exc h-f-nk-sp b9+marg 0.5/<
- 11421Exc h-f-nk-sp b9+marg 0.6-1
- 11422Exc h-f-nk-sp b9+marg 1.1-2
- 11423Exc h-f-nk-sp b9+marg 2.1-3
- 11424Exc h-f-nk-sp b9+marg 3.1-4
- 11426Exc h-f-nk-sp b9+marg >4 cm
- 11440Exc face-mm b9+marg 0.5 cm/<
- 11441Exc face-mm b9+marg 0.6-1 cm
- 11442Exc face-mm b9+marg 1.1-2 cm
- 11443Exc face-mm b9+marg 2.1-3 cm
- 11444Exc face-mm b9+marg 3.1-4 cm
- 11446Exc face-mm b9+marg >4 cm
- 11450Exc skn hdrdnt ax smpl/ntrm
Are plastic surgery procedures performed in an ASC?
Yes. Many reconstructive and skin procedures are short and scheduled and do not require an overnight stay, which makes them well suited to the ambulatory surgery center setting. Whether Medicare pays a specific code in an ASC depends on its CMS addendum status. Codes on Addendum AA are on the ASC Covered Procedures List, while Addendum EE codes are excluded from ASC payment. Always confirm the status of the exact code before scheduling.
What CPT codes does plastic surgery use?
Most ASC-relevant plastic surgery work falls in the integumentary family, roughly CPT 11000 to 19499. This range includes debridement, skin grafts and flaps, wound repairs, and breast procedures. Examples are 19318 for breast reduction, 15734 for a muscle and skin flap on the trunk, and 11042 for subcutaneous tissue debridement. Our dataset maps 405 ASC-relevant codes to this specialty.
What place of service applies to plastic surgery in an ASC?
Place of service 24 applies when the procedure is performed in a freestanding ambulatory surgery center. Place of service 11 applies when the work is done in an office-based setting. The place of service reported should match where the service was actually delivered, and it interacts with the code's ASC coverage status and the medical-necessity documentation on file.