Summary & Overview
CPT 17280: Destruction of Malignant Lesion ≤0.5 cm on Face or Mucous Membrane
CPT code 17280 denotes destruction of a malignant cutaneous or mucosal lesion on the face, ears, eyelids, nose, lips, or mucous membrane when the lesion is 0.5 cm or less in diameter. This code captures a common, targeted dermatologic procedure used to remove small malignancies with techniques such as chemosurgery, cryosurgery, or electrosurgery. Nationally, accurate coding for small malignant lesion destruction matters for clinical documentation, quality reporting, and appropriate claim adjudication.
Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for this procedure, the typical sites of service, and the service type. The publication summarizes benchmarking considerations, common billing modifiers supplied in the input, and policy and coverage considerations relevant to payers nationally. It also highlights areas where coding specificity (lesion size and anatomic site) drives correct code selection and potential reimbursement differences across payers.
This executive summary equips clinicians, coders, and policy analysts with the essential facts about CPT code 17280, outlines the scope of content in the full publication, and frames where payers and providers should focus documentation and claims submission efforts.
Billing Code Overview
CPT code 17280 describes destruction of a malignant lesion on the face, ears, eyelids, nose, lips, or mucous membrane using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The code applies when the malignant lesion measures 0.5 cm or less in diameter.
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Service type: Destruction of malignant cutaneous or mucosal lesion using ablative techniques.
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Typical site of service: Ambulatory clinic, dermatology office, outpatient surgical center, or other outpatient settings where minor dermatologic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a dermatology clinic with a biopsy-confirmed basal cell carcinoma measuring 0.4 cm on the lateral nose. The clinician documents a focused skin exam, reviews the biopsy pathology, discusses treatment options, and proceeds with office-based destruction of the lesion using cryosurgery under local anesthesia. The procedure is performed in the outpatient dermatology clinic; vital signs are monitored, informed consent is obtained, local anesthesia may be administered, and post-procedure wound care instructions are given. Clinic staff document lesion size, exact anatomic location (nose, left side), technique used (cryosurgery), and diagnosis. The typical workflow includes: pre-procedure evaluation and consent, preparation and photography of the lesion, administration of local anesthetic if required, lesion destruction using an appropriate modality, immediate post-procedure assessment, and documentation of follow-up instructions and plan for surveillance or additional treatment if margins or pathology require further care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure performed | When this destruction is the primary service during the visit |
22 | Increased procedural services | When documented work is substantially greater than usual (extensive localization, multiple lesions managed) |
23 | Unusual anesthesia | When general anesthesia or deep sedation is required for an otherwise minor procedure |
26 | Professional component | When billing separate professional component for interpretation or reporting (rare for this code) |
50 | Bilateral procedure | When identical malignant lesions are destroyed on both sides of a paired anatomic site and payer allows bilateral modifier usage |
51 | Multiple procedures | When multiple distinct procedures are billed on the same day and payer requires modifier to indicate multiplicity |
52 | Reduced services | When the procedure is partially reduced or not completed per documentation |
53 | Discontinued procedure | When the procedure is started but then terminated due to unforeseen circumstances |
59 | Distinct procedural service | When another procedure on the same date is distinct and separate from the lesion destruction |
62 | Two surgeons | When another surgeon is required to assist and co-surgeon reporting is applicable |
76 | Repeat procedure by same physician | When the same physician repeats the procedure later the same day |
78 | Return to operating/procedure room for related procedure during postoperative period | When an unplanned return to the procedure area for a related complication occurs |
79 | Unrelated procedure during postoperative period | When an unrelated procedure is performed during the global period |
LT | Left side | When the procedure is performed on the left anatomic site |
RT | Right side | When the procedure is performed on the right anatomic site |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207N00000X | Dermatology | Primary specialty performing skin lesion destruction procedures |
| 2073P0800X | Dermatopathology | Involved for biopsy interpretation when pathology guides management |
| 208D00000X | Plastic Surgery | May perform destructive or excisional procedures on cosmetically sensitive facial sites |
| 282N00000X | Otolaryngology | May manage lesions on nose, ears, or mucous membranes in head and neck region |
| 208000000X | General Surgery | May perform destruction or excision for malignant skin lesions in some settings |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.311 | Basal cell carcinoma of right ala of nose | Common malignant lesion requiring destruction on the nose |
C44.312 | Basal cell carcinoma of left ala of nose | Laterality-specific code for lesions on the opposite side |
C44.019 | Squamous cell carcinoma of skin of unspecified eyelid | Squamous cell carcinoma on facial/mucosal sites appropriate for destructive therapy |
C44.221 | Squamous cell carcinoma of right ear | Malignant lesion on the ear amenable to office destruction when small |
D04.9 | Carcinoma in situ of skin, unspecified | In situ lesions may be managed with destructive techniques depending on location and size |
C44.91 | Malignant neoplasm of skin, unspecified site | General code used when site specificity is not documented but malignancy is present |
Z48.02 | Encounter for removal of sutures | Relevant for follow-up care documentation after destructive procedures if applicable |
Z79.899 | Long term (current) use of other medications | May be relevant when documenting adjuvant topical chemotherapeutics or systemic therapies |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11102 | Tangential biopsy of skin (e.g., shave), single lesion | Performed to obtain tissue diagnosis prior to destruction when pathology is needed |
11100 | Biopsy of single lesion, punch | Alternative diagnostic biopsy method prior to definitive destruction |
17000 | Destruction of benign lesions, first lesion | When benign lesions are treated in the same encounter; distinguishes malignant-specific codes |
17286 | Destruction of malignant lesion, face/neck/ scalp/ankle/foot, lesion diameter 1.1 to 2.0 cm | Used when lesion size exceeds the 0.5 cm threshold for 17280 and requires a different code |
99024 | Postoperative follow-up visit global surgical package | Used by some practices to document routine postoperative follow-up depending on payer policies |