Summary & Overview
CPT 17261: Destruction of Malignant Lesion, Trunk/Arms/Legs 0.6–1.0 cm
CPT code 17261 covers the destruction of a malignant cutaneous lesion on the trunk, arms, or legs measuring 0.6–1.0 cm in diameter using methods such as chemosurgery, cryosurgery, electrosurgery, or other destructive techniques. This code is used broadly across outpatient dermatology and ambulatory care settings to bill for targeted lesion destruction and is relevant for national claims, coverage policy, and clinical documentation because accurate coding affects clinical reporting, reimbursement, and quality measurement for skin cancer management.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of standard clinical context for lesion destruction, common site-of-service considerations, and payer coverage touchpoints. The publication also summarizes benchmark rate ranges, policy and coverage updates that affect use of the code, and documentation elements needed to support medical necessity. Practical insights include comparisons to adjacent codes for different lesion sizes or anatomical locations and notes on billing nuances relevant to outpatient dermatologic practice.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or detailed payer-specific payment rates is noted where applicable.
Billing Code Overview
CPT code 17261 describes the destruction of a malignant lesion located on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or other destructive methods. The code applies when the lesion measures 0.6 cm to 1.0 cm in diameter.
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Service type: Destruction of malignant cutaneous lesion (minor surgical/dermatologic procedure)
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Typical site of service: Ambulatory clinic, dermatology office, outpatient procedural suite, or other outpatient settings where minor surgical dermatologic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 67-year-old male presents to a dermatology clinic with a biopsy-proven squamous cell carcinoma in situ on the forearm. The lesion measures approximately 0.8 cm in greatest diameter. After review of options, the treating dermatologist schedules office-based destruction using cryosurgery. The clinical workflow includes pre-procedure consent and site marking, local anesthesia if indicated, lesion destruction using cryotherapy probe with documented lesion size and technique, short observation for complications, wound care instructions, and documentation of diagnosis, procedure details, and follow-up for surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or outpatient visit for evaluation and management | When an E/M service that meets criteria is performed and reported with the procedure (use per payer rules) |
22 | Increased procedural services | When the procedure requires substantially greater work than usual (must document rationale)
23 | Unusual anesthesia | When the procedure is performed under general or regional anesthesia unexpectedly (rare for this code)
| Reduced services | When the procedure is partially reduced or not completed (document extent)