Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms, or legs; lesion diameter over 4.0 cm

CPT 17266 is the billing code for "Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms, or legs; lesion diameter over 4.0 cm". Destruction of malignant lesion, trunk/arms/legs, >4.0 cm

Medicare pays approximately $229.01 for CPT 17266 (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 17266 has a total RVU of 5.50, broken down as: Work RVU 2.50, Practice Expense RVU 2.80, and Malpractice RVU 0.20. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 17266 include: Location documented (trunk/arms/legs); Size documented (>4.0 cm); Method documented; Malignancy documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 17266: Trunk/arms/legs only. Size >4.0 cm Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 17266 include: 59 (Distinct procedural service), 50 (Bilateral procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 17266 is Typically 35-45 minutes. Time-based codes require documentation of the actual time spent providing the service.