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CPT 17314: Mohs Micrographic Surgery for Malignant Skin Lesion
CPT code 17314 represents Mohs micrographic surgery, a precise, staged surgical technique for excising malignant skin lesions with immediate histopathologic margin assessment. Nationally, Mohs surgery is a key treatment modality for certain skin cancers because it maximizes tumor clearance while preserving healthy tissue, affecting surgical practice patterns, facility resource use, and payer coverage considerations. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical sites of service, and how 17314 fits within related Mohs procedure codes. The publication also outlines common billing relationships to adjacent codes used for Mohs procedures, summarizes typical payer coverage context, and highlights benchmarks and policy updates that influence reimbursement and coding practice. Clinical context provided helps align documentation and coding to the procedural stages inherent in Mohs micrographic surgery. Where available, benchmark comparisons and recent policy clarifications are summarized to inform coding accuracy and claims submission. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 17314 describes Mohs micrographic surgery, a multi-staged technique for excising malignant skin lesions layer by layer with immediate histopathologic assessment to ensure negative margins. The procedure is performed by specially trained surgeons and typically involves sequential removal of tissue specimens, microscopic examination, and targeted re-excision until margins are free of tumor.
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Service type: Surgical oncology/procedural dermatology (Mohs micrographic surgery)
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Typical site of service: Outpatient surgical centers or hospital outpatient departments where same-day tissue processing and pathology review can be performed.
National Reimbursement Benchmarks
Nationally, the BUCA commercial benchmark averages $716.20, which sits notably above Medicare’s mean of $400.10, indicating commercial contracts pay roughly $316.10 more on average for CPT 17314 than Medicare. Blue Cross Blue Shield and UnitedHealth Group also report higher means ($926.50 and $511.50 respectively), reinforcing a commercial premium relative to Medicare; Aetna and Cigna cluster lower among national commercial means but still above some Medicare localities.
Dispersion (P75 minus P25) highlights variability across payers: Blue Cross Blue Shield has the widest interquartile spread at $470.00 ($1,164.50 - $677.00), followed by UnitedHealth Group at $325.00 ($658.50 - $313.00). The tightest spreads are Aetna at $268.70 ($407.60 - $180.90) and Cigna at $334.30 ($591.00 - $250.70). BUCA’s interquartile range is $369.00 ($902.20 - $493.20); Medicare’s middle spread is $43.00 ($414 - $371).