CPT 17250Surgery

Chem caut of granltj tissue

CPT 17250 covers chemical cauterization of granulation tissue—when a healthcare provider uses a chemical agent (often silver nitrate) to remove excessive tissue growth that can occur during wound healing or in chronic wounds.

Showing rates for

National Average

Base Medicare rate

$82.16

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

0.5

PE RVU (NF)

1.97

MP RVU

0.07

Total RVU

2.54

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

NCCI bundling edits

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Billing tips

Document the exact location and size of the granulation tissue and photograph when possible
Impact: Reduces denials by 40-50% by establishing medical necessity; photographic documentation strengthens appeals and audit defense
Bill in non-facility settings when possible rather than hospital outpatient departments
Impact: Increases reimbursement by 125% ($82.16 vs $36.55) for the same service; office-based procedures are significantly more profitable
Do not bill 17250 with routine wound care codes (97597, 97598) on the same date without modifier 59 and clear documentation of separate sites
Impact: NCCI edits will bundle these services; improper modifier use can trigger audits and recoupment of $82-$300+ depending on wound care complexity
For pediatric umbilical granulomas, ensure diagnosis coding includes L92.9 or P83.6 to establish medical necessity
Impact: Using generic or incorrect diagnosis codes results in 30-35% denial rate; proper ICD-10 coding is essential for first-pass payment
Bill for each separate application session, not each individual silver nitrate stick used
Impact: CPT 17250 is per session, not per unit; billing multiple units on same day without modifier 76 will result in denial of all but the first unit
When performed with E/M service, document that the decision to cauterize was made after the examination and represents separately identifiable work
Impact: Without clear documentation of separate decision-making, modifier 25 claims face 25-30% denial rates with potential downcoding to E/M only

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 17250 in 2025?

The 2025 Medicare national average reimbursement for CPT 17250 is $82.16 in non-facility settings and $36.55 in facility settings, based on the CMS Physician Fee Schedule with a conversion factor of 32.3465.

Can CPT 17250 be billed with an office visit on the same day?

Yes, CPT 17250 can be billed with an E/M service on the same day using modifier 25, but documentation must clearly show the E/M service was separately identifiable and medically necessary beyond the decision to perform the chemical cauterization.

How many times can CPT 17250 be billed for the same patient?

There is no specific limit, but each session must be medically necessary and documented. Frequent billing for the same site may trigger payer audits requiring justification of why the condition hasn't resolved with previous treatments.

What diagnosis codes support medical necessity for CPT 17250?

Common supporting diagnoses include L92.9 (granuloma, unspecified), P83.6 (umbilical granuloma of newborn), L89.x (pressure ulcers with granulation), and L98.4 (chronic ulcer of skin). The diagnosis must demonstrate the clinical significance of the hypergranulation tissue.

Is CPT 17250 included in the global surgical package?

Chemical cauterization of granulation tissue may be considered part of post-operative care if performed during the global period for surgical site complications. Use modifier 78 or 79 if billing during a global period, with documentation supporting it as an unplanned return for a complication.

What is the RVU value for CPT code 17250?

CPT 17250 has a total RVU of 2.54, consisting of 0.5 work RVU, 1.97 non-facility practice expense RVU (0.56 facility), and 0.07 malpractice RVU based on the 2025 Medicare Physician Fee Schedule.

Does CPT 17250 require prior authorization from Medicare or commercial payers?

Medicare typically does not require prior authorization for CPT 17250, but some Medicare Advantage and commercial plans may require it, especially for multiple treatments. Always verify individual payer policies before performing the procedure to avoid payment delays.