D7413 — Excision of malignant lesion — up to 1.25 cm
D7413 removes a malignant lesion up to 1.25 centimetres across.
This is one of eleven closely related biopsy and lesion excision codes. The treatment is explained in full in the biopsy and lesion excision guide — this page is about what makes this particular code different.
Below is what the code actually specifies, the fee range to expect, how dental benefits normally handle it, and the specific differences between it and the codes it is most often confused with.
What has to be true for D7413 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.
Where the line falls between D7413 and the rest
D7412 — Excision of benign lesion — complicated: It is the complicated variant, requiring a supporting narrative.
D7414 — Excision of malignant lesion — greater than 1.25 cm: It is the large-lesion version.
D7411 — Excision of benign lesion — greater than 1.25 cm: It is the large-lesion version.
D7415 — Excision of malignant lesion — complicated: It is the complicated variant, requiring a supporting narrative.
D7413 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. The safest question to ask is not "what does this cost" but "which code is going on the claim". The first answer changes; the second decides the first.
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 D7413
D7413 — what is it?
Excision of malignant lesion, up to 1.25 cm. It belongs to the oral and maxillofacial surgery section of the code set.
Is D7413 expensive?
Between $700–$1,800 in most practices — and that is the figure before any benefit is applied, not what you would pay at the desk.
Is D7413 a covered benefit?
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 D7413 and D7412?
D7412 is excision of benign lesion, complicated: it is the complicated variant, requiring a supporting narrative. Nothing else separates them, which is exactly why a claim submitted under the wrong one of the two is such a common correction.
Also known as: oral biopsy, mouth lesion, oral cancer, lesion excision, pathology.