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    OpenPayerBilling CodesMohs Micrographic Surgery ProceduresCPT cpt-17311-mohs-micrographic-surgery-first-stage-head-neck-hands-feet-genitalia
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    CPT 17311: Mohs Micrographic Surgery, First Stage

    Medicare pays $691 and commercial payers pay $959 on average nationally for this procedure.

    CPT code 17311 describes Mohs micrographic surgery, first stage performed to excise a malignant skin lesion with intraoperative histopathologic margin assessment, typically a multi‑stage surgical and pathology procedure; service type: surgical excision with intraoperative pathology (Mohs surgery); typical site of service: outpatient dermatology clinic or ambulatory surgical center where staged excision and frozen‑section or processed tissue examination are performed.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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    National Reimbursement Benchmarks

    Commercial averages sit well above Medicare for CPT 17311: Blue Cross Blue Shield, Cigna, UnitedHealth Group, Aetna, and BUCA all report mean commercial rates higher than Medicare’s mean of $691.20, with BUCA’s mean at $959.00 representing the closest commercial average to Medicare. This positions Medicare below the commercial cluster while BUCA serves as an intermediate commercial benchmark between lower and higher-paying plans.

    Dispersion measured as the interquartile difference (P75–P25) varies notably: Blue Cross Blue Shield and UnitedHealth Group show the widest IQRs at $504.30 (BCBS $1323.40−$816.10) and $585.40 (UnitedHealth Group $1168.60−$582.60), indicating broader variability in contracted rates. Aetna and Cigna are comparatively tighter with IQRs of $412.90 (Aetna $852.90−$416.00) and $580.90 (Cigna $1053.40−$470.50); BUCA’s IQR is $528.50 (BUCA $1195.50−$676.20).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient presents to a dermatology clinic with a biopsy-proven basal cell carcinoma on the left nasal sidewall. The lesion is clinically suspicious for aggressive or ill-defined margins. The dermatology team schedules 17311 Mohs micrographic surgery. On the day of service, the Mohs surgeon performs staged excisions in an outpatient dermatologic surgery suite equipped for frozen-section processing. After each tissue layer is removed, specimens are mapped and submitted to the on-site dermatopathology technician for horizontal frozen-section histologic assessment. If tumor is detected at the margin, the surgeon returns to remove additional staged tissue until margins are clear. Once negative margins are achieved, the surgeon reconstructs the defect using local tissue rearrangement. Clinical documentation includes preoperative lesion description and biopsy results, intraoperative stage maps and number of tissue blocks, pathology reports for each stage, time in and out, anesthesia type, and reconstruction details. Typical payors for this outpatient procedure include Medicare, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthCare, and commercial employers (BUCA).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    17312Mohs micrographic surgery, each additional stage after first (use with 17311)

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207ND0900X
    207NS0135X
    207N00000X
    2080P0214X
    363LA2200X
    335U00000X
    202C00000X
    281PC2000X

    Related ICD-10-CM Codes

    16 rows

    ICD-10-CM CodeDescription
    C00.0Malignant neoplasm of external upper lip
    C00.1Malignant neoplasm of external lower lip
    C00.3Malignant neoplasm of upper lip, inner aspect
    C00.4Malignant neoplasm of lower lip, inner aspect
    C00.6Malignant neoplasm of commissure of lip, unspecified
    C00.8Malignant neoplasm of overlapping sites of lip
    C43.0Malignant melanoma of lip
    C43.111Malignant melanoma of right upper eyelid, including canthus
    C43.112Malignant melanoma of right lower eyelid, including canthus
    C43.121Malignant melanoma of left upper eyelid, including canthus

    Showing 1–10 of 16

    Related Payer Policy Updates

    Specialty: Dermatology1 / 2

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-17312-MOHS-MICROGRAPHIC-SURGERY-FOR-SKIN-MALIGNANCY

    CPT 17312: Mohs Micrographic Surgery, Additional Stage

    CPT-17313-MOHS-MICROGRAPHIC-SURGERY-SKIN-LESION-EXCISION

    CPT 17313: Mohs Micrographic Surgery, First Stage, Trunk/Arms/Legs

    CPT-17314-MOHS-MICROGRAPHIC-SURGERY-SKIN-LESION

    CPT 17314: Mohs Micrographic Surgery for Malignant Skin Lesions

    CPT-17315-MOHS-MICROGRAPHIC-SURGERY-SKIN-CANCER-EXCISION

    CPT 17315: Mohs Micrographic Surgery per Tissue Stage

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Billed for each additional Mohs stage when tumor persists at margin beyond the first stage.
    17313Mohs micrographic surgery first stage, trunk, arms, or legsAlternative primary Mohs code when lesion is on trunk or extremities rather than head/neck sites.
    17314Mohs micrographic surgery, each additional stage after first for trunk, arms, or legs (use with 17313)Billed for additional stages on trunk/limb Mohs procedures.
    17315Mohs micrographic surgery, each additional tissue block after the first 5 blocks in a stageBilled when more than five tissue blocks are submitted in a single Mohs stage to reflect increased laboratory workload.