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CPT 17312: Mohs Micrographic Surgery for Cutaneous Malignancy
CPT code 17312 represents Mohs micrographic surgery, a specialized, multi-staged surgical technique for excising cutaneous malignancies with immediate microscopic margin assessment. The procedure is nationally significant because it combines high cure rates with maximal tissue preservation, making it a preferred approach for high-risk or cosmetically sensitive skin cancers. Payers commonly referenced in analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise briefing on clinical context, payer coverage scope, and coding relationships for Mohs surgery billed under CPT code 17312. Readers will find an overview of service definitions and typical sites of service, comparison to closely related Mohs codes used for other anatomic sites or additional stages, and pointers to key operational and billing considerations. The summary highlights national relevance for dermatology and surgical oncology practices, expected use cases for high-risk basal and squamous cell carcinomas, and the role of Mohs surgery in preserving function and cosmesis.
Data elements that inform coding, payer policy variation, and common billing modifiers are presented for operational use. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 17312 describes Mohs micrographic surgery, a staged excisional procedure in which a malignant skin lesion is removed layer by layer with immediate histopathologic examination of margins. The technique is used to achieve complete tumor removal while preserving healthy tissue.
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Service type: Surgical excision with intraoperative histologic margin assessment (Mohs micrographic surgery)
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Typical site of service: Outpatient dermatologic surgical suite or ambulatory surgery center specializing in skin cancer surgery
National Reimbursement Benchmarks
Commercial averages exceed Medicare for CPT 17312: BUCA’s mean of $746.90 stands well above Medicare’s mean of $417.80, indicating that BUCA reimbursements are, on average, about $329.10 higher than Medicare for this code. Blue Cross Blue Shield, UnitedHealth Group, and Cigna all sit between these points, with their means closer to BUCA than to Medicare, while Aetna’s mean is nearer to Medicare. Dispersion varies notably across payers. Blue Cross Blue Shield shows the widest interquartile spread at $500.10 (P75 $1,179.90 minus P25 $687.90), reflecting broader pricing variability, followed by UnitedHealth Group with a spread of $348.90 and BUCA with $222.20. Aetna and Cigna exhibit the tightest IQRs at $277.00 and $356.60 respectively, indicating relatively more clustered commercial rates around their medians.