US · guidance
CMS Pub. 100-03, ch. 1, § 140.4
Plastic Surgery to Correct “Moon Face”
CIM 35-12
Not Covered
The cosmetic surgery exclusion precludes payment for any surgical procedure directed at improving
appearance. The condition giving rise to the patient’s preoperative appearance is generally not a
consideration. The only exception to the exclusion is surgery for the prompt repair of an accidental injury or
for the improvement of a malformed body member which coincidentally serves some cosmetic purpose.
Since surgery to correct a condition of “moon face” which developed as a side effect of cortisone therapy
does not meet the exception to the exclusion, it is not covered under Medicare (§1862(a)(10) of the Act).
Cross reference: The Medicare Benefit Policy Manual, Chapter 16, “General Exclusions From Coverage,”
§120.
History
(Rev. 1, 10-03-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
4ba3752ad85753290bc5a3f17ad82fc1f3202eb44efd38affd01eb08a177adfd
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