CPT Code 10040: Acne Surgery (e.g., Marsupialization or Opening of Cystic Acne Lesions)

You generally cannot bill CPT Code 10040 multiple times per visit because the code describes treatment of multiple acne lesions in one procedure, and CPT guidelines typically allow only one unit per date of service regardless of the number of lesions treated.

Insurance may cover acne surgery, such as CPT 10040, when it is medically necessary. For example, in cases of severe or cystic acne that doesn’t respond to standard treatments like topical medications or oral antibiotics. Coverage can vary, so it’s important to check with your provider, especially if you’ve already tried other methods of treating acne.

CPT Code 10040 is generally intended for severe or persistent acne involving cysts, comedones, milia, or pustules that require surgical intervention, so it is not typically appropriate for mild or non-cystic acne. For non-cystic acne, less invasive treatments or other codes may be more suitable.