Bill Juvederm breast injections with one code from CPT 11950 to 11954, picked by the total volume injected in the session. Report the product with an unlisted drug code and a narrative. But expect no payment: the FDA has not approved dermal fillers for breast use, and Medicare excludes cosmetic surgery by law. Most practices collect from the patient up front.
Reviewed by Manikandan J, CPC, CRCR on October 14, 2026. On this date we checked the FDA filler guidance, Medicare’s cosmetic exclusion and the ABN rules. We fixed two errors: Q2026 and Q2028 are not hyaluronic acid codes, and an ABN is not required for a cosmetic service. We also removed payer policy claims we could not confirm.
Table of Contents
Key takeaways
- CPT 11950, 11951, 11952 and 11954 cover a shot of filling material under the skin. You pick the code by total volume.
- The FDA has not approved dermal fillers such as Juvederm for breast augmentation (FDA, dermal fillers).
- Medicare does not cover cosmetic surgery (Medicare Benefit Policy Manual, Ch. 16, §120).
- Most of these visits are self-pay. A claim is sent only when the patient needs a formal denial.
The 11950 to 11954 range
CPT 11950 to 11954 are the codes for a filler shot placed under the skin. The AMA’s code text gives collagen as an example, but the example does not limit the code. Hyaluronic acid fillers like Juvederm fit too. See how CPT codes work if you are new to the code set.
You pick the code by volume alone. The table below paraphrases the ranges; check your current CPT book for the exact wording.
| CPT code | Total volume in the session |
|---|---|
| 11950 | 1 cc or less |
| 11951 | 1.1 to 5.0 cc |
| 11952 | 5.1 to 10.0 cc |
| 11954 | More than 10.0 cc |
For example, say the doctor injects 3 cc in each breast. The total is 6 cc, so you bill 11952 once. Do not bill 11951 twice, one for each side. The code is built on the total for the session.
The drug code that goes with it
The CPT code covers the injection. The product is billed on its own line. Juvederm has no HCPCS code of its own, so billers use J3490 (unclassified drugs) or the code the payer tells you to use. Add the product name, the amount and the lot details in the claim note. On a paper claim that note goes in Box 19 of the CMS-1500.
Do not use Q2026 or Q2028. Q2026 is for Radiesse and Q2028 is for Sculptra. Neither is a hyaluronic acid product, so they do not fit Juvederm.
Why these claims do not pay
The trouble is not the code. It is coverage. Juvederm is a medical device the FDA approved for the face, such as lines, lips and cheeks. The FDA’s filler page recommends against using fillers to increase breast size, and says that use is not approved. So breast use is off-label.
Medicare spells out its rule in the Benefit Policy Manual, Chapter 16, section 120: cosmetic surgery is not covered. This is a rule in the law, not a choice the payer makes. Most commercial plans also leave out cosmetic care. Read the patient’s plan papers or the payer’s filler policy to be sure.
When a Medicare claim is sent to get a formal denial, add the GY modifier. GY tells Medicare the service is excluded by law. The denial will often come back as CO-96, a non-covered charge.
Do you need an ABN?
No. An ABN (Advance Beneficiary Notice) is the form that warns a Medicare patient that Medicare may not pay. CMS’s ABN booklet says you do not need one for a service Medicare never covers, such as cosmetic surgery. You may give one as a courtesy so the patient knows the cost. If you do, add the GX modifier next to GY. The patient does not have to sign a courtesy ABN. Many offices use their own self-pay form instead.
Workflow: how plastics billers handle it
- Check the plan first. Look up the payer’s filler or cosmetic policy before the visit.
- Quote the cost. Give the patient a written price for the shot and the product.
- Collect up front. Take payment before or at the visit.
- Code the chart anyway. Record the 11950 to 11954 code, the volume and the product, even if no claim goes out.
- Send a claim only if asked. Some patients want a denial for a health savings plan or a second payer. Use the codes in the table below.
| Claim part | What to use | Note |
|---|---|---|
| Procedure | 11950, 11951, 11952 or 11954 | One code, by total cc for both sides |
| Product | J3490 or the payer’s chosen code | Add the name and amount in the claim note |
| Diagnosis | Z41.1 | Encounter for cosmetic surgery |
| Medicare modifier | GY | Service excluded by law |
| Side | Ask the payer | Some want LT and RT; the volume code still covers both sides |
Key terms in plain English
- Off-label use means using a device or drug for a purpose the FDA did not approve.
- Statutory exclusion means the law itself bars Medicare from paying.
- Self-pay means the patient pays the practice directly, with no claim.
FAQ
What CPT code is used for Juvederm breast injections?
Use one code from 11950 to 11954, picked by the total volume for both sides.
Is Juvederm FDA approved for the breast?
No. The FDA has approved it for the face only. The FDA recommends against using fillers to increase breast size.
Will insurance pay for it?
Almost never. Medicare excludes cosmetic surgery, and most plans do too. Plan to collect from the patient.
Should I bill the two sides as two codes?
No. Add the volume from both sides and bill one code.
Have a denial question or a topic you want covered?
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