D7410 — Excision of benign lesion — up to 1.25 cm
D7410 removes a benign lump or patch measuring up to 1.25 centimetres, with the specimen sent for laboratory diagnosis.
This code belongs to a set of eleven covering biopsy and lesion excision. The clinical detail lives in the biopsy and lesion excision guide; the code-level detail is here.
What the number specifies, what it costs, what your plan is likely to do with it, and the named differences between it and the codes around it — in that order.
What has to be true for D7410 to apply
Size — up to 1.25 centimetres. The measurement has to be recorded in the chart; it is what separates this code from the large-lesion code beside it.
The nearby codes and how they differ
D7411 — Excision of benign lesion — greater than 1.25 cm: It is the large-lesion version.
D7412 — Excision of benign lesion — complicated: It is the complicated variant, requiring a supporting narrative.
D7413 — Excision of malignant lesion — up to 1.25 cm: It is the same procedure with one word changed: malignant rather than benign.
D7414 — Excision of malignant lesion — greater than 1.25 cm: It is the large-lesion version.
D7410 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. Because the wording of these codes is so close, substituting one for another is a routine cause of rejected claims and of unexpected balances. If D7410 is on your estimate, it is worth confirming that the detail it specifies matches what is actually planned.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
Questions about D7410
What procedure is D7410?
Excision of benign lesion, up to 1.25 cm, reported under a single oral and maxillofacial surgery code.
What should I expect to pay for D7410?
$400–$1,000 covers most of the country. Specialist practices and big-city addresses tend to sit in the upper half.
Will my plan pay for D7410?
Typically, yes — basic / major oral surgery benefits, typically 70–80%. What varies between plans is the frequency limit rather than whether the procedure is covered at all.
What is the difference between D7410 and D7411?
D7411 is excision of benign lesion, greater than 1.25 cm: it is the large-lesion version. The rest of the procedure is the same, which is why the two get substituted for one another on estimates.
Also known as: oral biopsy, mouth lesion, oral cancer, lesion excision, pathology.