CPT 17261 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 76 - Repeat procedure by same physician |
| Complexity Level | Low |
National average reimbursement for CPT 17261 by major payers:
$156.43
$179.20
$186.58
$238.39
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 17261 | ||||||
United | 17261 | $149.05 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | 17261 | $186.30 | 1790793487 - CLIVE LIU | 270750186 - (WA) CLIVE LIU, MD PLLC | WA | Dermatology Physician (207N00000X) |
United | 17261 | $1400.00 | 1538177589 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $764.00 | 1538623640 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL REFERENCE LABORATORY | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | 17261 | $150.25 | 1124170691 - WILLIS KNIGHTON MEDICAL CENTER, INC., WILLIS KNIGHTON SOUTH HOSPITAL | 720400933 - (LA) WILLIS-KNIGHTON MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | 17261 | $682.00 | 1932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA | 270059959 - (LA) NMC OPERATING COMPANY, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 17261 | $1275.00 | 1396731105 - DOCTORS HOSPITAL OF LAREDO, DOCTORS HOSPITAL OF LAREDO | 233001904 | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $142.30 | 1669606646 - JOHN C HILDENBRAND IV LLC | 264563139 - (LA) JOHN C HILDENBRAND IV LLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 17261 | $2500.00 | 1992815195 - OCHSNER BAPTIST MEDICAL CENTER | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 17261 | $1956.00 | 1679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $660.00 | 1184911877 - VHS BROWNSVILLE HOSPITAL COMPANY LLC, VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $114.76 | 1700802733 - SCOTT PETRIE | 721446271 - (LA) THE ORTHOPAEDIC AND SPORTS CLINIC (APMC) | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 17261 | $116.55 | 1003192311 - EL CAMPO MEMORIAL HOSPITAL | 452750258 - (TX) EL CAMPO MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $853.00 | 1619270188 - VALLEY BAPTIST MEDICAL CENTER | 452663071 | TX | General Acute Care Hospital (282N00000X) |
United | 17261 | $177.00 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 17261 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 17261 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 17261 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 17260-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 0.5 Cm Or Less |
| 17261-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 0.6 To 1.0 Cm |
| 17262-CPT | Low | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 1.1 To 2.0 Cm |
| 17263-CPT | Moderate | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 2.1 To 3.0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 17261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 17261 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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