CPT 17280Surgery

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CPT 17280 covers the destruction (removal by freezing, burning, or laser) of a small cancerous skin lesion on the face, ears, eyelids, nose, lips, or mucous membranes, when the lesion is 0.5 cm or less in diameter.

Showing rates for

National Average

Base Medicare rate

$137.15

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

1.22

PE RVU (NF)

2.89

MP RVU

0.13

Total RVU

4.24

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

NCCI bundling edits

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Billing tips

Always confirm biopsy-proven malignancy before billing 17280; destruction of benign lesions requires different codes (17000 series for benign)
Impact: Using 17280 for benign lesions constitutes incorrect coding and can result in $137.15 overpayment per lesion, audit liability, and potential fraud allegations
Choose setting carefully: non-facility rate ($137.15) is 60% higher than facility rate ($85.72), representing $51.43 difference per lesion
Impact: Performing procedures in office-based setting increases revenue by $51.43 per lesion compared to hospital outpatient department
Use add-on code 17281 for each additional lesion destroyed on the same date; 17281 has its own reimbursement and should never be billed alone
Impact: Properly using 17281 for multiple lesions can add $70-90 per additional lesion; billing 17280 multiple times instead will result in denials
Document lesion size precisely with measurement in centimeters; lesions >0.5 cm require different codes (17281 for 0.6-1.0 cm range has different payment)
Impact: Incorrect size documentation can result in downcoding or upcoding allegations; size determines code selection across the entire 17280-17286 series
Link appropriate diagnosis codes (C44.xx series for malignant neoplasm of skin) with specific anatomic subsite matching the lesion location
Impact: Generic or incorrect diagnosis codes are a top denial reason; specific anatomic ICD-10 codes are required for medical necessity validation
Bill on the date of destruction, not the biopsy date; if biopsy and destruction occur same day, bill both with modifier 25 on E/M if performed

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Frequently asked questions

What is the Medicare reimbursement for CPT code 17280 in 2025?

Medicare pays $137.15 for CPT 17280 in non-facility settings and $85.72 in facility settings under the 2025 Physician Fee Schedule. The total RVU is 4.24 with a work RVU of 1.22.

Can I bill CPT 17280 for destruction of a benign lesion?

No, CPT 17280 is exclusively for malignant lesions confirmed by biopsy. Benign lesion destruction uses codes 17000-17004 (premalignant) or 17110-17111 (benign). Using 17280 for benign lesions is incorrect coding and may constitute fraud.

How many times can I bill CPT 17280 on the same date of service?

CPT 17280 should be billed only once per date of service for the first malignant lesion destroyed. Additional malignant lesions on the same anatomic areas are reported with add-on code 17281, which can be billed multiple times.

What anatomic locations are covered by CPT code 17280?

CPT 17280 covers malignant lesions on the face, ears, eyelids, nose, lips, and mucous membranes. Lesions on trunk, arms, or legs use different codes (17260-17266 series). The anatomic location must be precisely documented.

Do I need a biopsy before billing CPT 17280?

Yes, malignancy must be confirmed by pathology before destruction can be coded as 17280. The pathology report should clearly document malignant diagnosis (basal cell, squamous cell, melanoma in situ, etc.). Clinical diagnosis alone is insufficient.

What is the difference between CPT 17280 and 17281?

CPT 17280 is the primary code for the first malignant lesion ≤0.5 cm on face/ears/eyelids/nose/lips/mucosa. CPT 17281 is an add-on code for each additional lesion in the same session. 17281 cannot be billed alone and must accompany 17280 or larger lesion codes.

Can I bill an E/M visit with CPT 17280 on the same day?

Yes, but only if a separately identifiable evaluation and management service was performed, and you must append modifier 25 to the E/M code. The E/M must be above and beyond the usual pre-procedure assessment and be clearly documented as a distinct service.