Summary & Overview

CPT 17274: Destruction of Malignant Skin Lesion, 3.1–4.0 cm

CPT code 17274 covers the destruction of a malignant skin lesion measuring 3.1 cm to 4.0 cm in diameter using methods such as chemosurgery, cryosurgery, electrosurgery, or other destructive techniques. This procedure code is used in outpatient settings and is important for documenting and billing definitive, local tumor control when excision is not performed or feasible. Nationally, accurate use of the code affects clinical documentation, payment consistency, and quality measurement for skin cancer management.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines which payers recognize the code, typical reimbursement considerations, and common billing modifiers used in practice. It also situates the code within clinical workflows—primarily dermatology and surgical outpatient services where lesion-specific destructive procedures are performed.

Readers will find benchmarks for utilization and reimbursement patterns, an explanation of clinical scenarios where this code applies, and summaries of payer policy features relevant to coverage and prior authorization. Data gaps in the input are noted as "Data not available in the input." This summary is intended to support clinicians, coding professionals, and policy analysts who need a concise reference to CPT code 17274 and its role in malignant skin lesion treatment billing.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare17274CPTdermatologyskin-cancerdestruction-procedureoutpatient-surgerycryosurgeryelectrosurgery

Billing Code Overview

CPT code 17274 describes the destruction of a malignant skin lesion measuring 3.1 cm to 4.0 cm in diameter. Techniques referenced include chemosurgery, cryosurgery, electrosurgery, or other destructive methods.

Service Type: Destruction of malignant lesion

Typical Site of Service: Outpatient procedure settings such as dermatology clinics, ambulatory surgery centers, or hospital outpatient departments, focusing on lesions located on the scalp, neck, hands, feet, or genitalia.

Clinical & Coding Specifications

Clinical Context

A 68-year-old male presents to a dermatology clinic with a biopsy-confirmed malignant cutaneous lesion located on the scalp measuring 3.5 cm in greatest diameter. The lesion was previously biopsied in an outpatient clinic visit, pathology confirmed invasive squamous cell carcinoma. The patient is evaluated by a board-certified dermatologist with procedural privileges. After pre-procedure consent and topical anesthesia plus local infiltration, the provider performs destruction of the malignant lesion using electrosurgery/fulguration with adequate margins and hemostasis. The procedure is documented with lesion location (scalp), size (3.5 cm), technique (electrosurgery), estimated blood loss, anesthesia used, and that the lesion is malignant. The service is furnished in an outpatient dermatology procedure suite; operative note, pathology (if submitted), and post-procedure instructions are included in the chart. Billing is submitted with 17274 for destruction of a malignant lesion on the scalp measuring between 3.1 cm and 4.0 cm in diameter. Appropriate ICD-10 diagnosis code(s) for the malignant skin lesion are linked on the claim, and applicable modifiers are appended based on payer requirements and the clinical circumstances (for example, professional component, bilateral sites, or significant unrelated E/M). Follow-up care and any additional treatments (excision, reconstruction, or oncology referral) are documented in the patient record.

Coding Specifications

Modifier	Description	When to Use
`11`

Taxonomy Code	Specialty	Notes
207N00000X	Dermatology	Primary specialty performing skin lesion destruction and outpatient cutaneous procedures.
207P00000X	Dermatopathology	Involved when pathology review or frozen section is required for diagnosis confirmation.
207L00000X	Mohs Micrographic Surgery	Dermatologic surgeons who may manage complex malignant skin lesions; destruction codes used when appropriate technique applied.
207RH0000X	General Surgery	General surgeons at times perform destructive skin procedures on scalp/neck in operative settings.
363LF0000X	Plastic and Reconstructive Surgery	Involved when reconstruction or more extensive excision follows destruction or when complex wound care is needed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C44.219`	Squamous cell carcinoma of skin of other part of face, unspecified	Common cutaneous malignancy that may be treated by destructive modalities when appropriate.
`C44.311`	Basal cell carcinoma of scalp and neck	Basal cell carcinoma on scalp/neck amenable to destructive treatment depending on size and location.
`C44.292`	Squamous cell carcinoma of skin of scalp and neck, other	Malignant scalp/neck lesions of the size range for `17274`.
`C44.51`	Basal cell carcinoma of trunk	Malignant skin lesions elsewhere that may require different CPT selection; included for clinical context.
`D04.0`	Carcinoma in situ of skin of scalp and neck	In situ lesions may be treated with destructive techniques depending on clinical judgment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11102`	Tangential biopsy of skin, single lesion; initial or shave biopsy	Performed before definitive destructive treatment to obtain diagnostic tissue.
`11606`	Excision, malignant lesion including margins, trunk, arms, legs; excised diameter 2.1 cm to 3.0 cm (includes simple closure)	Alternative definitive treatment when excision with margins is chosen instead of destruction for malignant lesions of certain sizes/locations.
`11646`	Excision, malignant lesion including margins, scalp, neck, hands, feet; excised diameter 3.1 cm to 4.0 cm (includes simple closure)	Surgical excision option for scalp/neck lesions in the same size range as `17274`; used when excision preferred over destructive modalities.
`17000`	Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement); first lesion	Used for destruction of benign lesions; listed to contrast malignant `17274` and for multiple lesion billing sequences.
`99024`	Postoperative follow-up visit, global service days	Used for routine postoperative visits related to the procedure during the global period when applicable.