D7411 — Excision of benign lesion — greater than 1.25 cm
D7411 removes a benign lesion larger than 1.25 centimetres, which means wider margins and more closure than the small-lesion code.
There are eleven codes for biopsy and lesion excision and they are not interchangeable. This page covers this one; the biopsy and lesion excision guide covers the treatment they all share.
Everything below is specific to this code: what it pins down, what it is worth, how a payer handles it, and which codes it is not.
What D7411 specifies
Size — greater than 1.25 centimetres. A larger lesion means wider margins, more closure and a longer appointment, and the measured dimension has to appear in the record to support the code.
The nearby codes and how they differ
D7410 — Excision of benign lesion — up to 1.25 cm: It is the small-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 small-lesion version.
D7414 — Excision of malignant lesion — greater than 1.25 cm: It is the same procedure with one word changed: malignant rather than benign.
D7411 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. It is worth asking the practice to point to which of these applies. The fees are not close, and the wording is, which is precisely the combination that produces disputed bills.
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 D7411
D7411 — what is it?
D7411 records excision of benign lesion, greater than 1.25 cm — one of the oral and maxillofacial surgery codes.
What is the typical fee for D7411?
Expect $600–$1,500. Ask for the number in writing, because the code carries no fee of its own and every practice sets its own.
Is D7411 a covered benefit?
Most plans include it under basic / major oral surgery benefits, typically 70–80%. A pre-treatment estimate is the only way to know your own number in advance.
What is the difference between D7411 and D7410?
D7410 is excision of benign lesion, up to 1.25 cm: it is the small-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.