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CPT 17311: Mohs Micrographic Surgery, First Stage (Sensitive Sites)
CPT code 17311 represents the first stage of Mohs micrographic surgery for anatomically sensitive sites such as the head, neck, hands, feet, or genitalia. Mohs surgery is performed in stages with immediate histopathologic examination of excised tissue to confirm tumor-free margins. Nationally, this code is central to the management of cutaneous malignancies where tissue conservation and margin control are priorities.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context explaining the role of Mohs surgery, typical sites of service, and how 17311 relates to follow-on codes for additional stages and tissue blocks. The publication also summarizes payer coverage considerations and common billing practices tied to staging and site specificity.
The report delivers benchmarks and policy-relevant notes useful for practice administrators, coders, and dermatologic surgeons—covering code usage hierarchy, related CPT codes for additional stages and tissue blocks, and payer-aligned coding patterns. Data on utilization trends, reimbursement benchmarks, or payer-specific policies are included where available; if certain payer-specific details are not provided in the input, those items are noted as Data not available in the input.
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Billing Code Overview
CPT code 17311 describes Mohs micrographic surgery, first stage for head, neck, hands, feet, or genitalia. The procedure is a multi-staged surgical excision performed to remove malignant skin lesions layer by layer with immediate microscopic pathological assessment of margins to ensure complete tumor clearance.
Service Type: Mohs micrographic surgery (procedural oncology/dermatologic surgery)
Typical Site of Service: Outpatient surgical setting or ambulatory surgery center, typically in a dermatology or dermatologic surgery clinic
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).