Traditional MedicareCoverageMedium impact
Cosmetic and Reconstructive Surgery
Medicare/CMS - LCD·Plastic Surgery, General Surgery, Orthopedics +3 more·Local Coverage Determination
Effective date
May 21, 2026
We identified it
Jun 17, 2026
Summary
New Local Coverage Determination L39506 for Cosmetic and Reconstructive Surgery from CGS Administrators becomes effective May 21, 2026. This policy will establish coverage criteria and billing guidelines for cosmetic and reconstructive surgical procedures under Medicare.
Action Required
By May 21, 2026: Billing team must review the full LCD L39506 policy at cms.gov to identify specific coverage criteria, affected CPT codes, and documentation requirements for cosmetic and reconstructive surgery procedures. Update billing system with any new prior authorization requirements and ensure providers understand medical necessity documentation standards for covered reconstructive procedures.