CPT 17262Surgery

Dstrj mal les t/a/l 1.1-2.0

CPT 17262 covers the removal of a cancerous skin lesion measuring 1.1 to 2.0 centimeters on the trunk, arms, or legs using methods like laser, freezing, or chemical destruction. This code is used when the lesion is confirmed or suspected to be malignant and is removed without traditional surgical excision.

Showing rates for

National Average

Base Medicare rate

$173.05

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

1.63

PE RVU (NF)

3.56

MP RVU

0.16

Total RVU

5.35

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify site of service before procedure: non-facility setting pays $65.01 more ($173.05 vs $108.04)
Impact: Strategic scheduling in office vs hospital can increase revenue by 60% per procedure
Measure lesion size before destruction begins and document in millimeters or centimeters; 1.0 cm lesion uses 17261 ($147.35) while 1.1 cm uses 17262 ($173.05)
Impact: Accurate measurement documentation prevents downcoding and potential $25.70 revenue loss per case
Confirm anatomic location precisely: hands/feet require 17270-17272 codes, scalp/neck/hands/feet/genitalia require 17280-17286 codes which reimburse differently
Impact: Incorrect location coding can result in underpayment or overpayment and audit risk
Do not bill 17262 with surgical excision codes (11600-11646) for the same lesion; choose one treatment modality per lesion
Impact: Bundling edits will deny second code; appeals rarely successful due to NCCI edits
Document pathology confirmation of malignancy or strong clinical suspicion with specific features; benign lesion destruction uses different codes (17110-17111)
Impact: Lack of malignancy documentation results in denial and recoding to lower-paying benign destruction codes
Bill only one destruction code per lesion regardless of multiple treatment sessions if within global period; subsequent treatments use modifier 58 or 78 as appropriate
Impact: Duplicate billing without modifiers results in 100% denial of second claim

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 17262?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 17262 in 2025?

Medicare pays $173.05 for CPT 17262 in non-facility settings (office) and $108.04 in facility settings (hospital outpatient department) based on the 2025 national average Medicare Physician Fee Schedule. Actual rates may vary by geographic location based on locality adjustments.

How many times can you bill CPT 17262 on the same date of service?

You can bill CPT 17262 multiple times on the same date if destroying multiple distinct malignant lesions that each meet the size criteria (1.1-2.0 cm). Each lesion must be separately documented with its own size and location. Modifier 59 may be required by some payers to indicate distinct lesions.

What is the difference between CPT 17262 and 17261?

CPT 17261 is for malignant lesions 0.6 to 1.0 cm, while 17262 covers lesions 1.1 to 2.0 cm on trunk, arms, or legs. The size difference results in different reimbursement: 17261 pays $147.35 while 17262 pays $173.05 in non-facility settings. Accurate pre-destruction measurement is critical for correct code selection.

Can CPT 17262 be billed with an office visit on the same day?

Yes, CPT 17262 can be billed with an E/M office visit (99202-99215) on the same day if the E/M service is separately identifiable and significant beyond the usual pre-procedure assessment. Modifier 25 must be appended to the E/M code, and documentation must clearly show distinct services.

What documentation is required to bill CPT 17262?

Required documentation includes: lesion size measurement (1.1-2.0 cm), specific anatomic location on trunk/arms/legs, evidence of malignancy (pathology or clinical description), destruction method used, and medical necessity. Pre-treatment photographs and pathology reports strengthen documentation and reduce audit risk.

Does CPT 17262 have a global period?

Yes, CPT 17262 has a 10-day global period. This means normal postoperative care for 10 days after the procedure is included in the reimbursement and cannot be billed separately. Unrelated E/M services during this period require modifier 24, and complications requiring return to treatment area need modifier 78.

What are the Work RVUs for CPT code 17262?

CPT 17262 has 1.63 Work RVUs, 3.56 non-facility Practice Expense RVUs, 1.55 facility Practice Expense RVUs, and 0.16 Malpractice RVUs, totaling 5.35 non-facility RVUs for 2025. These RVUs are multiplied by the conversion factor of $32.3465 to determine Medicare payment rates.