Summary & Overview

CPT 17276: Destruction of Malignant Cutaneous Lesion >4.0 cm

CPT code 17276 captures the destruction of a malignant cutaneous lesion greater than 4.0 cm in diameter on anatomically sensitive locations including the scalp, neck, hands, feet, or genitalia. As a procedure-level dermatologic code, it defines scope of service and supports claims for non-excisional destructive treatment using chemosurgery, cryosurgery, electrosurgery, or other destructive modalities. Nationally, accurate use of this code affects reimbursement, quality measurement, and coding consistency for high-acuity skin cancer management performed in outpatient and ambulatory surgical settings.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides readers with benchmarks on coding and utilization patterns, clarifies clinical context for when destruction (rather than excision) is reported, and summarizes relevant policy considerations and recent payer instructions where available. Readers will find concise guidance on expected sites of service, common clinical scenarios covered by this code, and an overview of documentation elements typically associated with billing for large-diameter malignant lesion destruction. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare17276CPTdermatologydestruction-of-malignant-lesioncutaneous-oncologyoutpatient-procedurecryosurgeryelectrosurgery

Billing Code Overview

CPT code 17276 describes the destruction of a malignant lesion greater than 4.0 cm in diameter using techniques such as chemosurgery, cryosurgery, electrosurgery, or other destructive methods. The procedure addresses malignant lesions located on the scalp, neck, hands, feet, or genitalia.

Service type: Destruction of malignant cutaneous lesion (surgical/dermatologic procedure)

Typical site of service: Outpatient surgical suite, dermatology clinic, or ambulatory procedure center

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old fair-skinned male with a history of sun exposure who presents to a dermatology clinic with a large, irregular, ulcerating lesion on the scalp measuring 4.5 cm in greatest diameter. Biopsy demonstrates invasive squamous cell carcinoma. The procedural plan is in-clinic destruction of the malignant lesion using electrosurgery with local anesthesia because the lesion is superficial, the patient prefers a non-excisional approach, and surgical resection with grafting is not indicated or feasible.

The clinical workflow includes: referral and biopsy confirmation of malignancy, pre-procedure informed consent and review of medical history and anticoagulation, pre-procedural lesion mapping and measurement, administration of local anesthesia, lesion destruction using electrosurgical/chemosurgical/cryosurgical technique, hemostasis and wound care instructions, documentation of lesion size (>4.0 cm), and post-procedure follow-up for wound healing and oncologic surveillance. Typical site of service is an outpatient dermatology clinic or ambulatory surgical center; service type is office-based ambulatory procedure for destruction of a malignant lesion larger than 4.0 cm on scalp/neck/hands/feet/genitalia.

Coding Specifications

Modifier	Description	When to Use
`11`	Office/outpatient E/M service	When an unrelated E/M visit is separately reported on the same day as the procedure and the provider performs the visit services.

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Most common specialty performing lesion destruction, including electrosurgery and cryosurgery.
`207P00000X`	Otolaryngology	Often treats scalp and neck malignancies; may perform or coordinate lesion destruction.
`207L00000X`	Plastic Surgery	Performs destruction or reconstruction when cosmetic or complex wound closure considerations exist.
`207K00000X`	General Surgery	Occasionally manages large cutaneous malignancies on trunk, scalp, or extremities when excision or destruction is part of surgical plan.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C44.311`	Squamous cell carcinoma of skin of scalp and neck	Common malignant skin tumor on sun-exposed scalp; may be treated by lesion destruction when appropriate.
`C44.419`	Squamous cell carcinoma of skin of other parts of face	Facial squamous lesions may require destruction or excision depending on size and depth.
`C44.51`	Basal cell carcinoma of skin of trunk	Basal cell carcinoma on non-facial sites; smaller lesions often excised, but destruction may be used for select lesions.
`C60.9`	Malignant neoplasm of penis, unspecified	Genital malignant lesions may be treated with destruction techniques depending on extent and location.
`C44.621`	Squamous cell carcinoma of skin of right hand	Hand lesions over 4.0 cm may be managed with destructive techniques when appropriate.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11102`	Tangential biopsy of skin, single lesion	Performed for initial diagnostic confirmation before definitive destruction of a malignant lesion.
`17000`	Destruction of premalignant lesion(s), up to 14 lesions	Used for actinic keratoses or premalignant lesions; not appropriate for malignant lesions >4.0 cm but may be performed concurrently for field treatment.
`17380`	Destruction of malignant lesion other than trunk, arms, legs; first lesion	Alternative destruction codes for malignant lesions smaller than threshold; used when lesion size or location differs.
`31540`	Laryngoscopy with biopsy, flexible or rigid	Example of site-specific diagnostic procedure when head/neck mucosal lesions are suspected in extended workup (contextual).
`12032`	Repair, intermediate, wounds of scalp, arms, and/or legs; 2.6 cm to 7.5 cm	May be performed if destruction is followed by surgical excision and layered wound repair or if excision becomes necessary after incomplete destruction.