CPT 17313Surgery

Mohs 1 stage t/a/l

CPT code 17313 covers the first stage of Mohs micrographic surgery, a specialized skin cancer removal technique where the surgeon removes tissue layer by layer and examines it under a microscope during the same visit to ensure all cancer cells are removed while preserving healthy tissue.

Showing rates for

National Average

Base Medicare rate

$621.38

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

5.56

PE RVU (NF)

13.06

MP RVU

0.59

Total RVU

19.21

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

NCCI bundling edits

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Billing tips

Bill 17313 only once per tumor/lesion regardless of how many tissue blocks are taken during the first stage
Impact: Prevents automatic denials; each tumor gets one first-stage code even with multiple blocks examined
Do not bill 17313 with pathology codes 88304-88309 for the same lesion - the microscopic examination is included in the Mohs code
Impact: Unbundling these codes will trigger denials and potential audit flags for improper coding practices
Use non-facility rate ($621.38) only when performed in office setting; facility rate ($307.94) applies in ASC/hospital outpatient settings
Impact: Setting determines rate - $313.44 difference per first stage; verify place of service code matches actual location
Document exact number of tissue blocks, stages performed, and margin status for each stage to support additional stage codes (17314-17315)
Impact: Each additional stage adds $259-$411 depending on setting; incomplete documentation risks denial of additional stages
Bill 17313 for trunk/arms/legs anatomic locations; use 17311 for head/neck/hands/feet/genitalia which reimburses higher
Impact: Using wrong anatomic code can result in $100+ payment difference; 17311 pays approximately $735 non-facility vs $621.38 for 17313
For multiple separate lesions on same day, bill 17313 for each tumor with modifier 59 or XS and clear documentation of distinct sites
Impact: Allows full payment for each tumor treated; without proper modifier, secondary tumors may be denied as duplicates

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 17313 in 2025?

The 2025 Medicare national average reimbursement for CPT 17313 is $621.38 in the non-facility (office) setting and $307.94 in the facility setting (ASC or hospital outpatient). Actual payment may vary by geographic location based on Medicare locality adjustments.

How many times can I bill CPT 17313 for the same patient on the same day?

You can bill 17313 once for each separate tumor/lesion treated during the same session. Each distinct tumor gets one first-stage code (17313), regardless of how many tissue blocks are examined. Use modifier 59 or XS with clear documentation showing separate anatomic sites for multiple tumors.

What is the difference between CPT 17313 and 17311?

The only difference is anatomic location. CPT 17311 is for Mohs first stage on head, neck, hands, feet, or genitalia. CPT 17313 is for trunk, arms, or legs. Code 17311 reimburses higher due to increased complexity and cosmetic sensitivity of those areas.

Can I bill pathology codes with CPT 17313?

No. The microscopic pathologic examination is included in Mohs codes 17311-17315. Billing separate pathology codes (88304-88309) for the same lesion constitutes unbundling and will be denied. The Mohs surgeon performs and is reimbursed for the pathology interpretation within the Mohs code.

When do I use 17313 versus 17314 or 17315?

CPT 17313 is for the first stage only. If additional tissue layers are needed because margins show remaining cancer, bill 17314 for each additional stage on the same tumor (up to 4 additional stages). For the 5th stage and beyond, use 17315 for each additional stage.

What documentation is required to bill CPT 17313?

Required documentation includes: pre-procedure biopsy confirming malignancy, operative report with stage number and tumor mapping, proof that the same physician performed surgery and microscopic examination, number of tissue blocks examined, margin status, exact anatomic location (trunk/arms/legs), and medical necessity for Mohs technique.

Does CPT 17313 include wound repair?

Simple closure (single layer) is included in 17313. However, intermediate repairs (layered closure, codes 12031-12057) and complex repairs (codes 13100-13160) may be billed separately when appropriate and documented. Adjacent tissue transfer/rearrangement codes (14000-14302) are also separately billable.