CPT 17272Surgery

Dstr mal les s/n/h/f/g 1.1-2

CPT code 17272 covers the destruction of premalignant skin lesions (such as actinic keratoses) on the scalp, neck, hands, feet, or genitals when the lesion measures between 1.1 and 2.0 centimeters in diameter. Common destruction methods include cryotherapy, laser, or chemical treatment.

Showing rates for

National Average

Base Medicare rate

$183.08

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

1.82

PE RVU (NF)

3.66

MP RVU

0.18

Total RVU

5.66

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

NCCI bundling edits

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Billing tips

Measure and document exact lesion size in centimeters before destruction; 17272 covers 1.1-2.0 cm only
Impact: Incorrect size documentation can result in $50-100 undercoding (if lesion is actually 2.1+ cm requiring 17273) or overcoding denials with recoupment demands
Verify anatomical location qualifies for 17272 series (scalp/neck/hands/feet/genitalia); other locations require 17000-17004
Impact: Using wrong code series results in immediate denial; 17272 pays $183.08 vs. $118.39 for comparable trunk/extremity codes, affecting revenue by $64.69 per lesion
Bill only one lesion per 17272 code; additional lesions on same day require 17273 add-on code
Impact: Billing multiple units of 17272 instead of 17272 + 17273 results in automatic denial of duplicate line items; proper sequencing ensures full payment for all lesions treated
Document destruction method, depth, and medical necessity (e.g., biopsy-confirmed dysplasia or clinical diagnosis)
Impact: Lack of pathology or clinical diagnosis leads to medical necessity denials; adding diagnosis documentation reduces audit recoupment risk by approximately 40%
Check NCCI edits before billing with same-day biopsies (11102-11107); modifier 59/XS may be required
Impact: NCCI bundles may automatically deny the biopsy or destruction without proper modifier; correct modifier use recovers $100-300 in bundled payments per encounter
Bill non-facility rate when performed in office setting; facility rate applies only in hospital outpatient or ASC
Impact: Place of service code determines rate: POS 11 (office) yields $183.08 vs. POS 22 (hospital outpatient) at $118.39, a difference of $64.69 per procedure

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Frequently asked questions

What is the Medicare reimbursement for CPT code 17272 in 2025?

Medicare pays $183.08 for CPT 17272 in non-facility settings and $118.39 in facility settings based on the 2025 national average rates. Actual payment may vary by geographic locality based on the GPCI adjustment factors.

How many RVUs is CPT code 17272 worth?

CPT 17272 has a total of 5.66 RVUs for 2025, consisting of 1.82 work RVUs, 3.66 practice expense RVUs (non-facility), 1.66 practice expense RVUs (facility), and 0.18 malpractice RVUs.

Can I bill CPT 17272 for multiple lesions on the same day?

No, CPT 17272 is reported only once for the first lesion measuring 1.1-2.0 cm. For each additional lesion destroyed on the same day, you must use add-on code 17273. Billing multiple units of 17272 will result in denial of duplicate charges.

What anatomical locations qualify for CPT code 17272?

CPT 17272 applies only to lesions on the scalp, neck, hands, feet, or genitalia. Lesions on the trunk, arms, legs, or other areas require different codes from the 17000-17004 series, which have different reimbursement rates.

What size lesion is coded with 17272?

CPT 17272 is specifically for lesions measuring 1.1 to 2.0 centimeters in diameter. Lesions 1.0 cm or smaller use code 17271, while lesions 2.1 to 3.0 cm use code 17273 as the first lesion (when applicable), and lesions over 3.0 cm use code 17274.

Does CPT 17272 require pathology confirmation?

While not absolutely required, pathology confirmation significantly reduces denial and audit risk. Clinical diagnosis by a qualified physician is acceptable, but payers may challenge medical necessity without biopsy confirmation, especially for higher-cost destructions. Document clinical features supporting premalignant diagnosis when pathology is not obtained.

Can I bill an E/M visit with CPT code 17272 on the same day?

Yes, you can bill an E/M service with CPT 17272 on the same day using modifier 25, but only if the E/M represents a separately identifiable service beyond the usual pre-procedure evaluation. Documentation must clearly show the E/M addressed issues distinct from the decision to perform destruction or involved significant separate decision-making.