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    v1.0.28
    OpenPayerBilling CodesCPT cpt-16034-dermatologic-procedure-outpatient
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    CPT 16034: Skin and Subcutaneous Defect Closure, Minor Surgical Repair

    CPT code 16034 describes a surgical procedure for closure of small skin and subcutaneous defects using grafting or complex layered closure techniques; the service is a minor soft tissue repair typically performed in an outpatient surgical setting such as an ambulatory surgery center or physician office with procedure-room capabilities.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult presenting to an outpatient dermatology clinic with one or more cutaneous benign or premalignant lesions (such as actinic keratoses, seborrheic keratoses, or small benign nevi) for which chemical or mechanical debridement with an application of an enzyme preparation is indicated. The workflow begins with history and focused skin examination, informed consent for topical enzymatic debridement, documentation of lesion location, size, and number, and photographic or diagrammatic recording when required. The procedure is performed in a procedure room or office dermatology suite: the area is cleaned, the enzyme agent is applied to the lesion(s) per manufacturer instructions, allowed to remain for the specified duration, and then removed; post-procedure wound care instructions are provided. Typical follow-up occurs in 1–4 weeks to assess response and healing, and additional treatments may be scheduled if necessary. The typical site of service is an outpatient clinic or dermatology office procedure room. The service type is dermatologic topical enzymatic wound or lesion debridement/chemical destruction consistent with billing code 16034.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11100Tangential biopsy of skin (e.g., shave, scoop), single lesionOften performed before or instead of enzymatic treatments to obtain tissue diagnosis of a suspicious lesion
    11101Tangential biopsy of skin, each additional lesion (List separately in addition to code for primary procedure)Used when multiple lesions are biopsied in the same session prior to or instead of 16034
    17000Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery), premalignant lesions (eg, actinic keratoses); first lesionMay be used as an alternative destructive method for premalignant lesions when chemical enzymatic methods are not chosen
    17003Destruction, premalignant lesions; 10 to 14 lesionsUsed for multiple premalignant lesions when grouped count applies; compared in workflow when multiple sites require treatment
    12001Simple repair of superficial wounds of scalp, skin, and subcutaneous tissue; 2.5 cm or lessMay be used if enzymatic debridement results in a wound requiring simple closure
    99070Supplies and materials (e.g., topical agents) provided by the physician over and above those usually included with the office visitUsed when special enzymatic agents or dressings supplied are billable beyond standard supplies
    99213Established patient office or other outpatient visit, typically 15 minutesCommon E/M level billed on same day if medically necessary evaluation beyond procedure is documented (use with modifier 25 when applicable)

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Y00000XOtolaryngology PhysicianAn otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ea…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    152WV0400XVision Therapy OptometristOptometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and r…
    261QM0855XAdolescent and Children Mental Health Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disord…
    251E00000XHome Health AgencyA public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing se…
    261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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