Summary & Overview
CPT 17286: Destruction of Malignant Lesion on Face Over 4.0 cm
CPT code 17286 denotes the destruction of a malignant skin lesion on cosmetically sensitive areas (face, ears, eyelids, nose, lips, or mucous membrane) when the lesion measures over 4.0 cm in diameter. This code captures a high-acuity, tissue-destructive dermatologic procedure that has implications for clinical workflow, coding specificity, and reimbursement across outpatient care settings. Nationally, the code matters because it distinguishes large malignant lesion destruction from smaller or benign procedures, affecting coverage determinations and payment levels.
Key payers in scope for this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context, common billing modifiers, and which service settings typically deliver this procedure. The publication summarizes benchmarks where available, clarifies coding boundaries versus related dermatologic destruction codes, and highlights policy and documentation elements that commonly influence payer determinations. Data not available in the input for some fields is noted where applicable.
Billing Code Overview
CPT code 17286 describes the destruction of a malignant lesion located on the face, ears, eyelids, nose, lips, or mucous membrane using techniques such as chemosurgery, cryosurgery, electrosurgery, or other destructive methods. The code specifically applies when the malignant lesion exceeds 4.0 cm in diameter.
Service type: Destructive procedure for malignant skin lesion.
Typical site of service: Outpatient procedure settings such as dermatology clinics, outpatient surgical centers, or hospital outpatient departments where minor surgical and destructive dermatologic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a dermatology clinic with a biopsy-confirmed invasive squamous cell carcinoma located on the lateral nose measuring 4.5 cm in greatest diameter. The lesion’s size and anatomic location place it within the head and neck region described by the code. The clinical workflow begins with evaluation and documentation of lesion size, photographic measurements, and review of pathology confirming malignancy. Pre-procedure informed consent and medical history (including anticoagulation status and comorbidities) are obtained. On the day of service, the patient is prepared in a minor procedure room or ambulatory surgical center; local anesthesia with possible sedation is administered, and the lesion is destroyed using an appropriate destructive modality (for example, electrosurgery or cryosurgery) with margins documented. Immediate post-procedure wound care instructions and follow-up are arranged for surveillance and reconstruction if needed. Billing is submitted for 17286 to reflect destruction of a malignant lesion on the face (greater than 4.0 cm), with documentation to support lesion size, technique used, anatomic site, and any concurrent services.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time is substantially greater than usual for 17286 and documentation supports increased complexity or difficulty. |
23 | Unusual anesthesia | Use if general anesthesia or deep sedation is used for the procedure that would not ordinarily be required. |
26 | Professional component | Use when reporting only the professional component of a service, if applicable to ancillary interpretation or reporting. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but halted due to patient-related or unforeseen circumstances. |
62 | Two surgeons | Use when two surgeons with distinct, documented surgical roles perform portions of the procedure. |
66 | Surgical team | Use when a surgical team approach is documented for a complex case involving multiple surgeons. |
76 | Repeat procedure by same provider | Use if the exact procedure 17286 is repeated by the same physician during the postoperative period. |
78 | Unplanned return to the operating/procedure room for related procedure during the postoperative period | Use when the patient requires an unplanned additional procedure related to the original service. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when a separate, unrelated procedure is performed during the global period. |
50 | Bilateral procedure | Use when the destructive procedure is performed bilaterally on paired anatomic structures and payer recognizes bilateral modifier application. |
51 | Multiple procedures | Use when 17286 is performed in the same session with other distinct procedures; list the primary procedure first as required. |
52 | Reduced services | Use when a documented portion of the service was intentionally reduced; (included here as clinically relevant when partial destruction occurs). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Dermatology | Most common specialty performing skin lesion destruction on the face and mucous membranes. |
207P00000X | Dermatopathology | Involved in diagnostic pathology review supporting a malignant diagnosis prior to destruction. |
208800000X | Otolaryngology | Performs procedures on head and neck lesions, particularly those near nasal or mucosal structures. |
207L00000X | Plastic Surgery | May perform or assist for large lesions on the face where reconstruction or more complex closure is anticipated. |
207R00000X | General Surgery | May be involved for large or deep cutaneous malignancies requiring multidisciplinary care. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.212 | Squamous cell carcinoma of skin of other part of face | Common cutaneous malignancy targeted for destructive treatments like 17286 when >4.0 cm. |
C44.219 | Squamous cell carcinoma of skin of face, unspecified | Used when specific face subsite is not detailed; supports medical necessity for lesion destruction. |
C44.302 | Basal cell carcinoma of skin of other part of eyelid, including canthus | Basal cell carcinoma on facial/mucosal sites may be managed with destructive modalities depending on size and depth. |
C44.312 | Basal cell carcinoma of skin of left ear | Large ear lesions may be treated with destruction or excision; code denotes anatomic site alignment with 17286. |
C44.91 | Malignant neoplasm of skin, unspecified | Used when documentation confirms malignant skin lesion without more specific coding; supports use of 17286. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
17260 | Destruction, premalignant lesion(s) (e.g., actinic keratoses); up to 14 lesions | Performed for premalignant lesions in the same session but not billed with 17286 which is for malignant lesion destruction >4.0 cm. |
17340 | Destruction of malignant lesion other than skin (e.g., mucosa) | May be used for destruction of mucosal malignancies depending on anatomic site and specifics; complements 17286 when mucous membrane involvement is specified. |
11606 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 cm to 4.0 cm | Represents surgical excision alternative for malignant lesions; used when excision with margins is performed instead of destruction. |
11646 | Excision, malignant lesion including margins, scalp, arms, legs; excised diameter over 4.0 cm | Relevant when a large malignant lesion requiring excision rather than destruction is managed; indicates alternative treatment pathway. |
12032 | Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm | Used when reconstruction or closure is required after excision or if destruction necessitates subsequent repair procedures. |