Summary & Overview
CPT 17003: Destruction of Premalignant Skin Lesions, Second Through 14th
CPT code 17003 is a critical billing code for dermatology and procedural skin care, representing the destruction of premalignant lesions—such as actinic keratoses—when treating the second through fourteenth lesion in a single session. This code is widely used in office-based dermatology practices and other CMS-approved care settings, reflecting the prevalence of skin lesion management in the United States. The procedure encompasses a range of destruction techniques, including laser surgery, electrosurgery, cryosurgery, chemosurgery, and surgical curettement, and is essential for preventing progression to skin cancer.
Major national payers covering this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a comprehensive overview of payer coverage, clinical context, and policy updates relevant to CPT 17003. Readers will gain insights into reimbursement benchmarks, coding nuances, and the role of this code in dermatology and procedural skin care. The analysis also addresses typical sites of service, common clinical indications, and related codes for destruction procedures, offering a clear understanding of how CPT 17003 fits into broader skin lesion management protocols. This summary is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date information on coding and coverage for destruction procedures.
CPT Code Overview
CPT 17003 is used to report the destruction of premalignant lesions, such as actinic keratoses, for the second through fourteenth lesion treated during a single encounter. This code covers procedures including laser surgery, electrosurgery, cryosurgery, chemosurgery, and surgical curettement. It is listed separately in addition to the code for the first lesion, reflecting the incremental nature of treating multiple lesions.
Service Type: Destruction procedures on benign or premalignant lesions of the integumentary system.
Typical Site of Service: Most commonly performed in the office setting (POS 11), but may also occur in other CMS-covered locations such as home (POS 12), assisted living (POS 13), group home (POS 14), temporary lodging (POS 16), and custodial care facility (POS 33).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a dermatology clinic with multiple premalignant skin lesions, such as actinic keratoses. The provider evaluates the lesions and determines that destruction is medically necessary. The first lesion is treated and coded with 17000. For the second through fourteenth lesions, each is treated using methods such as cryosurgery, electrosurgery, or laser surgery, and each additional lesion is coded with 17003. The procedure is performed in an office setting (Place of Service 11), but may also occur in other CMS-covered settings such as home, assisted living, or group homes. The workflow includes lesion identification, documentation, selection of destruction method, and post-procedure care instructions.
Coding Specifications
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Modifier
59: Used to indicate a distinct procedural service when multiple procedures are performed on the same day that are not normally reported together. -
Modifier
51: Used to indicate multiple procedures performed during the same session by the same provider.
| Modifier Code | Description |
|---|---|
59 | Distinct Procedural Service |
51 | Multiple Procedures |
- Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207N00000X | Dermatology |
207ND0101X | MOHS-Micrographic Surgery |
207NS0135X | Procedural Dermatology |
These taxonomies represent providers specializing in dermatology, MOHS surgery, and procedural dermatology, all of whom may perform destruction of premalignant skin lesions.
Related Diagnoses
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A63.0: Anogenital (venereal) warts- Relevant when destruction is performed on premalignant or benign anogenital warts.
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B07.0: Plantar wart- Used when treating plantar warts with destruction methods.
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B07.8: Other viral warts- Applies to destruction of other types of viral warts.
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B08.1: Molluscum contagiosum- Used for destruction of molluscum contagiosum lesions.
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D18.01: Hemangioma of skin and subcutaneous tissue- Relevant for destruction of hemangiomas on skin or subcutaneous tissue.
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D18.1: Lymphangioma, any site- Used when destruction is performed on lymphangiomas.
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D22.0: Melanocytic nevi of lip- Applies to destruction of melanocytic nevi located on the lip.
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D22.111: Melanocytic nevi of right upper eyelid, including canthus- Used for destruction of nevi on the right upper eyelid.
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D22.112: Melanocytic nevi of right lower eyelid, including canthus- Applies to destruction of nevi on the right lower eyelid.
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D22.121: Melanocytic nevi of left upper eyelid, including canthus- Used for destruction of nevi on the left upper eyelid.
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D22.122: Melanocytic nevi of left lower eyelid, including canthus- Applies to destruction of nevi on the left lower eyelid.
Each diagnosis code represents a condition for which destruction procedures may be clinically indicated and coded with 17003 when treating the second through fourteenth lesions.
Related CPT Codes
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17000: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions; first lesion- Used for the initial lesion treated in a session.
17003is listed separately for each additional lesion (second through fourteenth).
- Used for the initial lesion treated in a session.
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17004: Destruction Procedures on Benign or Premalignant Lesions of the Integumentary System; 15 or more lesions- Used when 15 or more lesions are treated in a single session. Replaces
17000and17003for high lesion counts.
- Used when 15 or more lesions are treated in a single session. Replaces
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17110: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular lesions; up to 14 lesions- Used for destruction of benign lesions (not premalignant), up to 14 lesions. Not used for premalignant lesions.
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17111: Destruction ... benign lesions other than skin tags or cutaneous vascular lesions; 15 or more lesions- Used for destruction of benign lesions (not premalignant), 15 or more lesions.
In clinical workflow, 17000 is used for the first premalignant lesion, 17003 for each additional lesion (second through fourteenth), and 17004 for 15 or more lesions. 17110 and 17111 are alternatives for benign lesions, not premalignant.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 17003 is highest with Aetna at $16.17, while Medicare's mean rate is $6.60. The BUCA (average commercial) mean rate stands at $9.82, notably higher than Medicare, reflecting a typical commercial premium for this service.
Rate dispersion varies across payers. Aetna shows the widest spread between the 25th and 75th percentiles ($15.33), indicating significant variability in contracted rates. In contrast, Medicare has the tightest range ($1.00), suggesting highly standardized reimbursement. Blue Cross Blue Shield and Cigna also display relatively narrow ranges ($3.52 and $4.50, respectively).
The table and chart below present a detailed breakdown of national mean rates and percentile values for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.