Summary & Overview
CPT 17264: Destruction of Malignant Lesion, Trunk/Arms/Legs 3.1–4.0 cm
CPT code 17264 represents destruction of a malignant skin lesion on the trunk, arms, or legs measuring 3.1 cm to 4.0 cm in diameter using methods such as chemosurgery, cryosurgery, electrosurgery, or other destructive techniques. This procedural code captures a distinct size tier for lesion destruction and is important for accurate clinical documentation, proper claims processing, and national utilization tracking of dermatologic oncologic procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage, coding guidance, and payment rates for lesion destruction procedures can vary across commercial plans and Medicare fee schedules, making precise code selection and documentation essential for reimbursement and quality reporting.
Readers will find an overview of the clinical context for lesion destruction, the service and typical sites of service, and what to expect in payer coverage and coding practice. The publication provides benchmark context, coding considerations related to lesion size and technique, and an outline of common modifiers (Data not available in the input for payer-specific rates and detailed policy variations). This national-level summary aids clinicians, billing staff, and policy analysts in understanding how CPT code 17264 fits into procedural coding workflows and payer interactions.
Billing Code Overview
CPT code 17264 describes 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 malignant lesion measures 3.1 cm to 4.0 cm in diameter.
Service type: Lesion destruction (oncologic dermatologic procedure)
Typical site of service: Outpatient clinic, physician office, or ambulatory surgical center
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to the dermatology clinic with a biopsy-confirmed cutaneous squamous cell carcinoma on the lateral right thigh measuring 3.5 cm in greatest diameter. The lesion is malignant and located on the trunk/upper or lower extremity. The clinical workflow includes pre-procedure evaluation (history, focused skin exam, and review of anticoagulation status), informed consent, lesion measurement and marking, local anesthesia administration, and lesion destruction using cryosurgery or electrosurgery in an outpatient clinic or ambulatory surgery center. Post-procedure wound care instructions are provided and a short follow-up visit is scheduled to assess healing and monitor for recurrence. Typical site of service is an outpatient dermatology clinic or ambulatory surgery center. Service type: lesion destruction (non-excisional) of a malignant lesion measuring 3.1–4.0 cm on trunk, arms, or legs, consistent with 17264.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. | Data not available in the input. |
26 | Professional component | Use when reporting only the professional component of a diagnostic service associated with the procedure. |
50 | Bilateral procedure | Use when the same procedure is performed on both sides of the body during the same session. |
51 | Multiple procedures | Use when multiple distinct procedures are performed at the same session in addition to 17264. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described by the full code. |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances. |
59 | Distinct procedural service | Use to indicate a distinct, separate procedure not normally reported together with another service. |
76 | Repeat procedure by same physician | Use when the same physician repeats the procedure later the same day. |
77 | Data not available in the input. | Data not available in the input. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use when the patient returns to the procedure room for a related procedure. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period. |
GT | Data not available in the input. | Data not available in the input. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Rare for this procedure; use only if anesthesia services meet the criteria. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Dermatology | Dermatologists most commonly perform cutaneous lesion destruction for malignant lesions on trunk and extremities. |
| 2080P0207X | General Surgery | General surgeons may perform lesion destruction in ambulatory surgery settings for larger cutaneous malignancies. |
| 207RN0200X | Dermatopathology | Dermatopathologists provide diagnostic confirmation (biopsy interpretation) supporting the procedure; they do not perform the destruction. |
| 208D00000X | Plastic Surgery | Plastic surgeons may perform lesion destruction or reconstructive procedures for malignant skin lesions requiring advanced wound management. |
| 363L00000X | Family Medicine | Family medicine physicians with procedural skills in skin surgery may perform lesion destruction in outpatient clinics. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.211 | Squamous cell carcinoma of skin of right upper limb including shoulder | Common malignant skin neoplasm treated with lesion destruction when appropriate. |
C44.212 | Squamous cell carcinoma of skin of left upper limb including shoulder | As above for left-sided lesions on arms/shoulder region. |
C44.291 | Squamous cell carcinoma of skin of unspecified upper limb including shoulder | Use when side is not specified; clinically relevant to decision for destructive therapy. |
C44.31 | Squamous cell carcinoma of skin of scalp and neck | Malignant lesion location differing from trunk/limbs; included due to clinical similarity in management options. |
C44.41 | Squamous cell carcinoma of skin of right lower limb including hip | Malignant lesion on lower extremity suitable for destruction when size and depth are appropriate. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11102 | Tangential biopsy of skin (e.g., shave, scoop), single lesion | Diagnostic biopsy performed prior to definitive destruction to establish malignancy. |
11606 | Excision, malignant lesion including margins, trunk, arms or legs; diameter 1.1 to 2.0 cm | Alternative definitive treatment when excision is chosen instead of destructive modalities for malignant lesions. |
17000 | Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (e.g., actinic keratoses), first lesion | Related destruction code for premalignant lesions; different diagnosis and code series. |
12032 | Repair, intermediate, wounds of trunk, arms or legs; 2.6 cm to 7.5 cm | May be performed if excision and primary closure are required instead of or following destructive procedures. |
99070 | Supplies and materials (except spectacles), used for medical purposes, unlisted devices | Used to report special supplies or devices consumed during the procedure when not otherwise included. |