2025 CPT code 17276
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Integumentary System - Destruction Procedures on Malignant Lesions of the Integumentary System Surgery Feed
Destruction of a malignant skin lesion (e.g., using laser, electrosurgery, cryosurgery, chemosurgery, or curettage) on the scalp, neck, hands, feet, or genitalia; lesion diameter over 4.0 cm.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., modifier 51 for multiple procedures, 22 for increased procedural services, 59 for distinct procedural service, 78/79 for unplanned return, etc.).
Medical necessity is established when there's a documented diagnosis of a malignant lesion that requires removal to prevent local spread, metastasis, and potential harm to the patient. The size of the lesion (over 4.0 cm in diameter) necessitates a destruction procedure and supports the medical necessity.
The physician's responsibility includes pre-operative assessment, determination of appropriate treatment method based on lesion characteristics, administration of local anesthesia (if applicable), performance of the lesion destruction, and appropriate post-operative care and documentation.
- Surgery
- Surgical Procedures on the Integumentary System > Destruction Procedures on the Integumentary System > Destruction Procedures on Malignant Lesions of the Integumentary System
In simple words: This code describes the removal of a cancerous skin growth larger than 4 centimeters (about 1.6 inches) on the scalp, neck, hands, feet, or genitals. The doctor uses methods such as laser, electrical current, freezing, chemicals, or scraping to remove the growth.
This CPT code, 17276, encompasses the destruction of malignant lesions located on the scalp, neck, hands, feet, or genitalia. The procedure involves the ablation of cancerous tissue using various methods, including but not limited to laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettage.The code is specifically applicable when the lesion's diameter exceeds 4.0 cm. Local anesthesia may be administered as needed.The choice of destruction method depends on the characteristics of the lesion and the physician's preference. Accurate documentation of the technique used and the lesion's size is crucial for proper coding and reimbursement.
Example 1: A 65-year-old male presents with a 5.0 cm malignant melanoma on his left hand. The physician performs electrosurgical destruction of the lesion under local anesthesia. , A 72-year-old female presents with a 4.5 cm squamous cell carcinoma on her scalp.The lesion is treated with cryosurgery, requiring local anesthesia. , A 50-year-old male presents with a large, irregularly shaped, 4.2 cm basal cell carcinoma on his neck. The physician performs laser ablation to remove the lesion.
Detailed patient history, including lesion size, location, and clinical presentation.Detailed description of the procedure performed, including the method of destruction, anesthesia used, any complications, and the amount of tissue removed.Pathology report confirming the malignant nature of the lesion and its complete removal.Photographs of the lesion before, during and after the treatment.
** Always refer to the most current CPT codebook and payer-specific guidelines for definitive information on coding and reimbursement.This information is for educational purposes only and should not be considered medical or legal advice.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: The RVUs for this code vary depending on the geographic location, facility type (inpatient vs. outpatient), and the specific resources used in the procedure.Consult a current RVU database or payer-specific fee schedules for the most accurate valuation.
- Global Days : The global period for this procedure is typically 0 days, meaning that separate postoperative visits are billed separately.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is generally not applicable for this code, as it represents the complete procedure.
- Fee Schedule : Historical fee schedules vary based on payer, location, and year.Consult a reputable fee schedule database or your payer’s specific historical records.
- Specialties:Dermatology, Surgical Oncology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)