CPT 17282Surgery

Dstr mal ls f/e/e/n/l/m1.1-2

CPT code 17282 covers the destruction of a malignant (cancerous) skin lesion measuring between 1.1 and 2.0 centimeters on the face, ears, eyelids, nose, lips, or mucous membranes. This typically involves freezing, burning, or using lasers to remove dangerous skin growths in cosmetically sensitive areas.

Showing rates for

National Average

Base Medicare rate

$199.90

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

2.09

PE RVU (NF)

3.88

MP RVU

0.21

Total RVU

6.18

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

NCCI bundling edits

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Billing tips

Always measure and document lesion size in centimeters before destruction begins, as tissue retraction post-procedure may reduce apparent size
Impact: Prevents downcoding from 17282 ($199.90) to 17281 ($153-175 range), protecting $25-45 per procedure
Verify anatomic location is within f/e/e/n/l/m (face, ears, eyelids, nose, lips, mucous membrane); trunk/extremity lesions use different code family (17260-17264) with lower reimbursement
Impact: Codes 17260-17264 reimburse 30-40% less; incorrect location coding can result in $60-80 underpayment per lesion
Bill in non-facility setting when possible; office-based procedures receive $66.63 higher reimbursement than facility-based
Impact: Direct financial impact: $199.90 vs $133.27, representing 50% higher revenue in office setting
Obtain and document pathology report confirming malignancy prior to destruction; medical record must support malignant diagnosis for 1728X codes
Impact: Without pathology confirmation, payers will deny and request recoupment or downcode to benign destruction codes (17000 series) at 60-70% reduction in payment
For lesions at size boundaries (exactly 1.1 cm or 2.0 cm), document measurement method and consider photographic evidence with measurement ruler
Impact: Reduces audit vulnerability and supports medical necessity; prevents post-payment recoupment averaging $150-200 per disputed claim
When performing multiple lesion destructions, use 17282 for first qualifying lesion and appropriate add-on codes for subsequent lesions of similar size
Proper sequencing with add-on codes (17283-17286) can add $100-150 per additional lesion versus incorrect use of modifier 59

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 17282 in 2025?

The 2025 Medicare national average reimbursement for CPT 17282 is $199.90 in non-facility settings and $133.27 in facility settings. The total RVU is 6.18 (2.09 work RVU, 3.88 non-facility PE RVU, 1.82 facility PE RVU, 0.21 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

What size lesion qualifies for CPT code 17282?

CPT 17282 is specifically for malignant lesions measuring 1.1 to 2.0 centimeters in greatest diameter. Lesions 1.0 cm or smaller use code 17281, while lesions 2.1-3.0 cm use code 17283. Accurate pre-destruction measurement documentation is critical for proper code selection.

Can I bill an E/M visit on the same day as CPT 17282?

Yes, you can bill a separate E/M service with CPT 17282 on the same day if the evaluation is separately identifiable and medically necessary beyond the normal pre-procedure assessment. You must append modifier 25 to the E/M code and document the distinct nature of the evaluation, such as addressing other medical conditions or performing initial consultation for the lesion.

What anatomic locations qualify for CPT 17282 versus other destruction codes?

CPT 17282 applies exclusively to lesions on the face, ears, eyelids, nose, lips, or mucous membranes (abbreviated f/e/e/n/l/m). Malignant lesions of the same size on the trunk, arms, legs, hands, feet, or genitalia use the 17260-17264 code series, which have different reimbursement rates and structure.

Do I need pathology confirmation before billing CPT 17282?

Yes, pathology confirmation of malignancy is required before performing and billing destruction with CPT 17282. The medical record must contain a pathology report documenting malignant diagnosis (basal cell carcinoma, squamous cell carcinoma, melanoma in situ, etc.) obtained via biopsy prior to the destruction procedure. Clinical suspicion alone is insufficient.

How do I bill for destruction of multiple malignant lesions on the face?

For multiple lesions, bill CPT 17282 for the first lesion in the 1.1-2.0 cm size range, then use appropriate add-on codes for additional lesions based on their individual sizes. The 17280-17286 code family includes size-specific codes; select each code based on individual lesion measurement, not cumulative size. Do not use modifier 59 for multiple lesions in the same code family.

What is the difference between facility and non-facility rates for CPT 17282?

The non-facility rate ($199.90) applies when the procedure is performed in a physician office where the practice bears all overhead costs. The facility rate ($133.27) applies when performed in a hospital outpatient department or ambulatory surgery center where the facility bills separately for overhead. The $66.63 difference reflects the practice expense component paid in office settings.