Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesion (e.g., actinic keratosis), first lesion

CPT 17000 is the billing code for "Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesion (e.g., actinic keratosis), first lesion". Destruction of first premalignant lesion using various methods

Medicare pays approximately $66.31 for CPT 17000 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 17000 has a total RVU of 1.14, broken down as: Work RVU 0.50, Practice Expense RVU 0.60, and Malpractice RVU 0.04. RVUs (Relative Value Units) determine Medicare reimbursement rates.

The most common denial reason for CPT 17000 is "Destruction of malignant lesion billed as premalignant - wrong code". 17000 (destruction premalignant lesion, first lesion) for actinic keratosis, premalignant lesions only. Malignant lesions (basal cell, squamous cell carcinoma) use different destruction codes (17260-17286) or excision codes. Denied when pathology shows malignancy but premalignant code billed. Common causes include: Lesion suspicious for cancer but billed as premalignant before path results; Biopsy-proven basal cell carcinoma destroyed - should use 17260-17286 (malignant destruction). Appeal success rate is approximately 10-30%.

Key documentation requirements for CPT 17000 include: Location of first lesion documented; Method of destruction documented; Type of lesion documented; Patient response to treatment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 17000: First lesion only. Use 17003 for 2-14 additional Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 17000 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 17000 is Typically 5-10 minutes. Time-based codes require documentation of the actual time spent providing the service.