CPT® Code 40500

The procedure known as vermilionectomy, specifically coded as CPT® Code 40500, involves the surgical removal of the vermilion portion of the lip, which is the pink to red area that is composed of modified mucosal membrane. The lips are anatomically divided into three distinct regions: the cutaneous, vermilion, and mucosal areas. The cutaneous region of the upper lip extends from the base of the nose to the nasolabial folds, while the lower cutaneous lip stretches from the vermilion border to the nasolabial folds and down to the mental crease at the chin. The vermilion area is crucial for aesthetic and functional purposes, and its excision is typically indicated for various pathological conditions. Vermilionectomy is performed to address issues such as actinic cheilitis, carcinoma in situ, and squamous cell carcinoma affecting the vermilion. During the procedure, an incision is made along the vermilion border of the affected lip, allowing for the excision of the vermilion tissue along the submucosal plane. Following this, the posterior lip mucosa is incised and developed to facilitate the reconstruction of the vermilion. The mucosal tissue is then advanced and carefully sutured to the cutaneous lip, effectively reconstructing the vermilion area.