CPT code 17284: Malignant lesion destruction, 3.1-4.0 cm

Key takeaways

CPT code 17284 covers destruction of a malignant lesion measuring 3.1 to 4.0 cm on the face, ears, eyelids, nose, lips, or mucous membrane.

All six codes in the 17280-17286 family share that body site group. Only the lesion diameter changes, and 17285 is not a valid code.

Lesions on the trunk, arms, or legs belong to 17260-17266. Scalp, neck, hand, foot, and genital lesions belong to 17270-17276.

Medicare’s 2026 national estimate is roughly $272 in an office and $165 in a facility, before any locality adjustment.

Pathology has to confirm malignancy before destruction, so keep the report, the measured diameter, and the photos in one patient record.

A 3.5 cm basal cell carcinoma destroyed on the nose is coded 17284. The code covers destruction of a malignant lesion measuring 3.1 to 4.0 cm on the face, ears, eyelids, nose, lips, or mucous membrane.

Two facts decide the code, and both have to come from the chart. One is where the lesion sits. The other is how wide it measured before treatment started.

Get either one wrong and the claim pays at the wrong rate, or it does not pay at all. Let’s dive in.

What CPT code 17284 covers

CPT code 17284 covers destruction of a malignant skin lesion measuring 3.1 to 4.0 cm across. Eligible sites are the face, ears, eyelids, nose, lips, and mucous membrane. That places the code in the integumentary system section of the American Medical Association’s CPT code set, inside the 17280-17286 family.

The official long descriptor reads as follows:

Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips and/or mucous membrane; lesion diameter 3.1 to 4.0 cm.

The treated site has to appear in the list, and the measured diameter has to land inside the 3.1 to 4.0 cm band. Note also that 17284 is not the top of its family. Anything wider than 4.0 cm belongs to 17286.

The code at a glance

Use this table at the point of coding. Every field comes from the AMA descriptor and the structure of the family around it.

One body site group, six size tiers

Every code from 17280 through 17286 describes the same body sites. Only the lesion diameter changes as you climb the family, so the measurement alone decides which of the six codes you bill.

Read the family as a size ladder on one set of sites. A lesion measured at exactly 3.0 cm is 17283. At 3.1 cm it becomes 17284, and at 4.1 cm it becomes 17286.

Measure the lesion, not the wound it leaves

Destruction codes use the greatest diameter of the lesion itself, taken before anything touches it. They do not use the defect left behind, and they do not add a surgical margin to the reading.

That margin rule belongs to the excision codes, where the excised diameter is the lesion plus the narrowest margin on each side. Borrowing it here inflates the tier and turns a correct 17283 into an overbilled 17284. Record the number to the nearest tenth of a centimeter, because the tissue is gone once destruction starts.

Why 17285 never appears on a claim

The CPT numbering skips 17285, so no lesion size maps to it. That same gap shows up in the two neighboring families, which skip 17265 and 17275. A claim carrying 17285 has no valid procedure code on it, so expect a rejection rather than a payment.

Lesions elsewhere on the body use a different family

Body site decides the family, and diameter decides the code inside it. Two other families cover malignant lesion destruction, and each one runs the same six size tiers.

The three numeric ranges never overlap, and none of them splits by site internally. A 3.5 cm lesion on the forearm is 17264. The same lesion on the nose is 17284.

The destruction method does not change the code

17284 is method-agnostic, so coders never pick a different code based on the technique the clinician used.

All of the following qualify:

• Laser surgery – ablative laser destruction of the malignant tissue
• Electrosurgery – high-frequency electrical current used to destroy lesion cells
• Cryosurgery – liquid nitrogen or another cryogenic agent freezes and destroys the lesion
• Chemosurgery – topical chemical agents destroy malignant cells, which is distinct from the Mohs chemosurgery technique
• Surgical curettement – physical scraping and removal of malignant tissue

Still, name the specific method in the operative note. Payers sometimes ask for documentation that separates destruction from excision, and the method is the fastest way to show it.

One boundary is worth holding onto. Vascular proliferative lesions such as port wine stains have their own destruction codes, 17106 to 17108, and those are never interchangeable with this family.

RVU values for CPT 17284 in 2026

RVU values drive Medicare payment through the Resource-Based Relative Value Scale, known as RBRVS.

The figures below come from the CY2026 CMS physician fee schedule relative value files, which were unchanged between the January and April 2026 releases.

The whole difference sits in practice expense. A non-facility total of 8.14 against a facility total of 4.95 reflects the room, the staff, and the consumables your practice pays for directly.

When the procedure happens in a hospital outpatient department or a surgery center, the facility rate applies to the physician’s claim. The facility then bills its own overhead separately.

Practices running dermatology billing at volume find that dermatology EMR software with fee schedule tracking keeps stale RVU data out of the charge master.

What Medicare pays for 17284

National payment starts with the total RVU multiplied by the annual conversion factor, which is $33.4009 for CY2026. Multiply the non-facility total of 8.14 and you get about $272. Do the same with the facility total of 4.95 and you get about $165.

Both figures are national unadjusted estimates with no Geographic Practice Cost Index applied. Actual payment moves up or down with the GPCI values in your locality, so a high-cost metro pays more than the number above.

Check your own rate in the CMS physician fee schedule lookup and select your MAC jurisdiction before you contract or quote a patient.

ICD-10 codes that support the claim

Every 17284 claim needs an ICD-10-CM diagnosis confirming malignancy at the documented site.

A diagnosis that is correct but vague causes most medical necessity denials in this family. Match the code to both the site and the confirmed cell type.

C44.111 and C44.121 are the unspecified-eyelid codes. Where the note names the side and the upper or lower lid, use the longer child code instead.

Verify each pairing against the current ICD-10-CM tabular list before the claim goes out.

Modifiers that keep the claim moving

Modifier use decides whether a claim for this code processes cleanly or sits on an NCCI edit hold. Apply each one only for its stated purpose.

Practice management software like Pabau keeps submitted claims and their status in one place while your team works those edits.

What the chart has to show before you bill

Thin documentation is the top audit trigger for integumentary destruction codes. Every element below has to sit in the medical record before you submit the claim. Capturing them with digital intake and consent forms at the point of care is far easier than reconstructing them afterwards.

• Pathological confirmation of malignancy – the biopsy result has to reach the chart before destruction goes ahead. Medicare LCD policy treats this as a requirement, not a preference. A punch biopsy carries its own code, 11105.
• Measured lesion diameter – record the diameter in centimeters in the operative note. A note reading 3.4 cm supports 17284, while 2.9 cm supports 17283.
• Anatomic site – name the exact site, such as “right lower eyelid” or “nasal tip”. The word “face” on its own will not carry a site-specific diagnosis code.
• Destruction method used – name the technique you used, whether cryosurgery, laser, electrosurgery, or another listed method.
• Pre-treatment and post-treatment notes – attach clinical photographs where you have them, and say why destruction beat excision here.

Practices with HIPAA-compliant documentation habits are in much better shape when a retrospective chart review lands. Standardized medical forms built for integumentary procedures also stop staff skipping required fields under time pressure.

A before-you-submit checklist

Run these six checks on the claim before it leaves the practice:

1. Pathology report filed, and dated before the destruction visit
2. Diameter in centimeters, taken pre-treatment, sitting in the operative note
3. Exact site named, with the side and the region where those apply
4. Destruction method recorded in the same note
5. Diagnosis code matching both the site and the confirmed cell type
6. Modifier 59 on every secondary lesion code on that date

How a 17284 claim actually moves

Knowing the code is one thing. Watching a single facial lesion travel from the first visit to a posted payment is what tells you where the money stalls.

1. Biopsy and pathology. The clinician samples the lesion and the report comes back malignant. Nothing bills as 17284 until that report reaches the chart.
2. Measurement and treatment. At the destruction visit the clinician measures the lesion first, and the number goes straight into the note. A 3.5 cm nasal lesion lands in the 17284 tier.
3. Charge capture. The coder pairs 17284 with a C44 diagnosis that matches the site and the cell type, then adds the place of service.
4. Submission. The claim leaves on an 837P through your billing system or clearinghouse. Front-end edits reject anything with a missing diagnosis within a day or two.
5. Adjudication. The MAC tests the diagnosis against its LCD and runs NCCI edits. A missing modifier 59 on a second lesion is the usual stopping point.
6. Payment. Medicare cannot pay an electronic claim before day 14, so that is the floor rather than the target. Paper claims wait 29 days.

Two of those six steps happen inside the treatment room, and they decide the other four. Practices comparing claims management platforms usually find the difference shows up at step three rather than step four.

Billing several malignant lesions on the same day

Bill each lesion destroyed in a single session under its own CPT code. The codes may repeat, or they may differ where the lesions sit on separate sites or fall in separate size tiers.

Three rules govern the claim:

1. Code each lesion separately by its own anatomic site and measured diameter. Never add two diameters together, and never combine lesions under one code.
2. Apply modifier 59 to the second and every later lesion code, so each reads as a distinct procedural service and clears NCCI bundling edits.
3. Document each lesion on its own in the operative note, with its measurement, its site description, and its pathology reference.

Some code pairs bundle under the National Correct Coding Initiative. Check the CMS NCCI edit tables before you submit several destruction codes on one date of service.

When Medicare covers CPT 17284

Medicare covers 17284 when the procedure meets medical necessity under the applicable Local Coverage Determination.

Criteria vary by MAC jurisdiction, but a few requirements hold almost everywhere:

• Pathological confirmation of malignancy documented before the procedure
• A lesion meeting both the anatomic site and the size criteria for the billed code
• Destruction as the clinically appropriate treatment, with a note on why it beat excision
• No prior conservative treatment step, since malignancy justifies treatment on its own

That last point separates this family from benign lesion removal, where payers often want a documented conservative attempt first. Beyond the common ground, individual LCDs add their own requirements, so read the one for your jurisdiction.

Groups working across several states through a plastic surgery EMR can configure payer rules per location and cut MAC-related denials that way.

Six errors that get 17284 denied

Most denials on this code trace back to a short list of repeat offenders. Each one is preventable with a habit at the point of care rather than a fix at the billing desk.

CPT 17284 vs Mohs surgery: Which code applies

Destruction and Mohs micrographic surgery both treat skin cancer, but they answer different clinical questions and carry different payer requirements. Mohs starts at 17311 for the first stage on the head and neck.

Choosing between the two is an oncological judgment, not a coding one. For billing, the point to hold onto is that each pathway has its own code family, documentation, and coverage rules. Never bill a destruction code when Mohs surgery was performed, or the reverse.

How Pabau keeps every coding detail in one record

In many practices this detail lives in three places at once. The measurement sits on a paper operative note. Someone’s phone holds the clinical photo, and an email folder holds the pathology report.

Your coder then chases all three before the claim can go out. When one of them will not turn up in time, the tier gets guessed, and that guess is what an auditor eventually finds.

Pabau holds them in the same patient file instead. Digital consent and intake forms capture the site and the measurement at the point of care. Treatment notes record the destruction method, and before-and-after photos attach to the same record.

So the path to submission gets shorter, and the chart stays complete. Your coder opens one record and finds the site, the size, the method, the photos, and the signed consent.

Keep every coding detail in one patient record

Pabau holds lesion measurements, clinical photos, consent forms, and treatment notes in one patient file, so your coder has the detail the claim needs.

Book a demo

Conclusion

Coding 17284 well is mostly a measurement discipline, not a coding one. Whoever holds the ruler decides the tier. The note has to carry a number in centimeters before treatment starts, and that number has to describe the lesion rather than the wound.

Build that one habit and most of the denials in this family disappear. It also settles the two questions an auditor will ask. Was the lesion malignant, and was it this wide?

The habit is hard to keep when measurements, photos, and pathology reports live in three systems. Pabau puts them in one patient record for dermatology and plastic surgery teams. Book a demo to see how that works in a skin cancer billing workflow.

Continue your research

Billing a lesion on the trunk, arms, or legs? CPT code 17260 opens the neighboring destruction family at 0.5 cm or less.

Treating a port wine stain instead? CPT code 17107 covers vascular lesion destruction between 10.0 and 50.0 square centimeters.

Billing a second Mohs stage? CPT code 17312 is the add-on for each stage after the first on the head and neck.

Working at the smallest facial tier? CPT code 17280 covers facial lesions of 0.5 cm or less, with the same documentation rules.

Need the pathology confirmed first? CPT code 11105 walks through punch biopsy billing, the step that has to precede destruction.

Frequently asked questions