Destruct b9 lesion 1-14
CPT 17110 covers the removal of 1 to 14 benign (non-cancerous) skin lesions using destruction methods like freezing, burning, or laser. This is typically done for warts, skin tags, or other harmless growths.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Count each individual lesion destroyed and document the exact number in the operative note. 17110 covers 1-14 lesions as a single unit; bill only once per session regardless of whether you destroy 1 or 14 lesions.
Impact: Billing error occurs when providers bill per lesion instead of per session, resulting in overpayment and potential $5,000-$20,000+ audit recoupment for high-volume practices.
When destroying 15 or more lesions, use CPT 17111 instead of 17110. Document the transition clearly if you reach the 15th lesion during the procedure.
Impact: CPT 17111 pays approximately $13-$25 more than 17110 and accurately reflects higher work. Using wrong code leaves money on table or triggers overpayment for incorrect code.
For facility billing, verify place of service code matches claim form. Non-facility rate ($109.98) is 63% higher than facility rate ($67.60).
Impact: Incorrect POS code can result in $42.38 underpayment per claim or trigger recoupment if non-facility rate paid for facility service. Annual impact for 100 procedures: $4,238.
Document medical necessity clearly in chart. Purely cosmetic lesion destruction is non-covered by Medicare and most insurance; functional impairment, pain, bleeding, or irritation establishes necessity.
Impact: Lack of medical necessity documentation is the #1 reason for denial. Results in 100% denial ($67.60-$109.98 per claim) with low appeal success rate without strong documentation.
Do not bill 17110 with malignant lesion destruction codes (17260-17286) for same anatomic site. Use appropriate malignant code if pathology is uncertain.
Impact: NCCI edits bundle these as mutually exclusive. Incorrect billing triggers automatic denial or postpayment audit with potential fraud investigation for pattern abuse.
For warts treated with multiple modalities on same day (e.g., paring then cryotherapy), bill only 17110. Paring/curettement is included and should not be separately billed with 11055-11057.
Impact: Unbundling these services violates CCI edits and results in denial of the bundled code ($30-$50 typical denial) plus potential compliance review for repeat offenses.
Common denials
Lack of medical necessity - lesion destruction deemed cosmetic without documented symptoms, functional impairment, or recurrent trauma
How to appeal: Submit appeal with detailed documentation of symptoms (pain, bleeding, catching on clothing), functional limitations, or recurrence history. Include clinical photos if available. Reference LCD/NCD guidelines for your MAC jurisdiction. Consider obtaining patient statement describing functional impact.
Incorrect unit billing - provider billed per lesion (e.g., 10 units for 10 lesions) instead of single unit for 1-14 lesions
How to appeal: Submit corrected claim with single unit and detailed operative note showing total lesion count. Include explanation that 17110 is billed once per session for 1-14 lesions per CPT guidelines. Request adjustment rather than recoupment for good-faith error. This is typically a non-appealable billing error requiring refund.
Bundling with E/M service - modifier 25 missing or insufficient documentation to support separate E/M service on same day
How to appeal: Provide complete E/M documentation showing separately identifiable service beyond the lesion destruction. Highlight elements of history, exam, and MDM unrelated to lesion. Emphasize decision to destroy lesion was made during E/M, not pre-scheduled. Add modifier 25 to corrected claim.
NCCI edit conflict with other procedure codes billed same date (commonly 11055-11057 paring/curettement codes or malignant destruction codes)
How to appeal: Review NCCI tables to confirm if override allowed with modifier. If distinct anatomic sites or truly separate procedures, resubmit with modifier 59 and detailed documentation of separate sites/sessions. If bundled without override, appeal is unlikely to succeed; consider if services were actually separately billable.
Frequently asked questions
What is the Medicare reimbursement for CPT 17110 in 2025?
Medicare pays $109.98 for CPT 17110 in non-facility settings and $67.60 in facility settings based on the 2025 national average rates. Actual payment varies by geographic location based on GPCI adjustments.
How many lesions can I destroy under CPT 17110?
CPT 17110 covers destruction of 1 to 14 benign lesions in a single session. You bill this code only once per session regardless of whether you destroy 1, 5, or 14 lesions. If you destroy 15 or more lesions, use CPT 17111 instead.
Can I bill an office visit and 17110 on the same day?
Yes, you can bill an E/M service with 17110 on the same day if the E/M represents a separately identifiable service beyond the lesion destruction. You must append modifier 25 to the E/M code and document the distinct service clearly in the medical record.
What is the difference between CPT 17110 and 17111?
CPT 17110 covers destruction of 1-14 benign lesions, while CPT 17111 covers 15 or more benign lesions. 17111 pays slightly more due to additional work. These codes are mutually exclusive; use only the code that matches your total lesion count for the session.
Does CPT 17110 require a pathology report?
No, CPT 17110 is for destruction of clinically diagnosed benign lesions and does not involve tissue submission for pathology. If tissue is sent for pathological examination, you may have performed excision (11400 series) or shave removal (11300 series) instead of destruction.
What are the RVUs for CPT code 17110?
CPT 17110 has 0.7 work RVUs, 2.64 non-facility PE RVUs (1.33 facility PE RVUs), and 0.06 malpractice RVUs, totaling 3.4 non-facility RVUs or 2.09 facility RVUs for 2025.
Is cryotherapy for warts covered by Medicare under 17110?
Yes, cryotherapy for warts is covered under CPT 17110 when medically necessary. Medical necessity requires documentation of symptoms (pain, bleeding), functional impairment, or failed conservative treatment. Purely cosmetic wart removal is not covered by Medicare.