Coding for a Preauricular Cyst

Question:

When coding for a preauricular cyst/pit, is 42810 or 1144x the correct CPT code?

Answer:

This is a great question. There is no single, dedicated CPT code labeled specifically for “preauricular cyst” or “preauricular pit,” so coders use existing excision codes based on location, depth, and closure type. The correct code depends on the operative note: exact location, how deep the tract/cyst extends, lesion/wound size, and closure type. Many otolaryngology coding references recommend 1144x plus appropriate closure codes for a straightforward preauricular cyst/pit excision, reserving 42810/42815 when the surgeon explicitly treats it as a branchial cleft–type vestige with deeper extension.

Commonly used CPT codes

For simple skin-level excision in the preauricular area (face/ear region):

• 11440–11446 – Excision, other benign lesion of face/ears (exact code chosen by lesion/excision size in cm).

If the surgeon documents, it as a branchial cleft–type vestige/cyst (extends to or beneath subcutaneous tissue):

• 42810 – Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues.

• 42815 – Excision branchial cleft cyst, vestige, or fistula extending beneath subcutaneous tissues and/or into pharynx.​

Closure coding (if not included in primary code):

• 12041–12057 – Layered/intermediate closure of face/ears, depending on wound length.

• 13131–13133 – Complex repair of face/ears, if documented as complex closure.

*This response is based on the best information available as of 03/05/26.