CPT 17106Surgery

Destruction of skin lesions

CPT 17106 covers the destruction of skin lesions (abnormal skin growths) using methods like freezing, burning, or laser treatment. This code is used when a provider removes multiple lesions in a single session.

Showing rates for

National Average

Base Medicare rate

$337.70

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

3.69

PE RVU (NF)

6.31

MP RVU

0.44

Total RVU

10.44

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify 17106 is billed as add-on code only with appropriate primary code (typically 17106 requires base code from same family); never bill as standalone
Impact: Prevents automatic denial; saves $337.70 claim rejection and 30-45 day appeal cycle
Document exact surface area treated in square centimeters or anatomical diagram to justify units billed
Impact: Supports medical necessity for higher RVU procedures; protects against $1,000+ downcoding in multi-unit claims
Bill non-facility rate ($337.70) when performed in office setting with owned equipment; facility rate ($271.39) applies to ASC/hospital
Impact: Captures additional $66.31 per procedure in appropriate settings, representing 24% revenue increase
Separate cosmetic from medically necessary lesions; obtain ABN (Advance Beneficiary Notice) for non-covered cosmetic treatments
Impact: Prevents compliance violations; allows patient collection of $300+ for cosmetic services Medicare won't cover
Use specific ICD-10 codes (D18.01-D18.09 for hemangiomas, I78.1 for nevus flammeus) rather than generic lesion codes
Impact: Reduces medical necessity denials by 40-60%; improves first-pass claim acceptance rate
For laser treatments, document laser type, settings (wavelength, fluence, pulse duration) and number of passes to support work RVU of 3.69
Impact: Withstands audits requesting procedure detail; protects $337.70 payment from post-payment recovery

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 17106 in 2025?

The 2025 Medicare national average reimbursement for CPT 17106 is $337.70 in non-facility settings (private office) and $271.39 in facility settings (hospital outpatient or ASC). Actual rates vary by geographic locality based on GPCI adjustments.

Can CPT 17106 be billed alone or does it require another code?

CPT 17106 is an add-on code and cannot be billed alone. It must be reported with an appropriate primary procedure code from the same code family. Billing 17106 as a standalone code will result in automatic claim denial.

How many RVUs is CPT code 17106 worth?

CPT 17106 has a total of 10.44 RVUs for 2025, consisting of 3.69 work RVUs, 6.31 non-facility practice expense RVUs (4.26 facility), and 0.44 malpractice RVUs.

Does Medicare cover CPT 17106 for cosmetic lesion removal?

No, Medicare does not cover 17106 for purely cosmetic lesion destruction. The lesions must be symptomatic (causing bleeding, pain, or functional impairment) or have medical necessity documentation. Providers should obtain an ABN before treating cosmetic lesions and bill the patient directly.

What modifiers are most commonly used with CPT 17106?

The most common modifiers for 17106 are modifier 59 (distinct procedural service for separate anatomical sites), modifier 25 (significant separate E/M service), and RT/LT (laterality modifiers for bilateral treatments). Modifier 52 may be used for reduced services.

What documentation is required to bill CPT 17106?

Required documentation includes lesion type and location, surface area measurements in square centimeters, destruction method with specific settings/technique, medical necessity justification, number of lesions treated, and patient response. Photographic documentation is strongly recommended for larger treatment areas.

What is the difference between facility and non-facility rates for 17106?

The non-facility rate ($337.70) applies when the physician owns the equipment and provides the treatment space in their private office. The facility rate ($271.39) applies when performed in a hospital outpatient department or ASC where the facility owns the equipment and space. The $66.31 difference reflects the practice expense component.