CPT 17264 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 • 99 - Other POS |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 79 - Unrelated procedure - postop period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 17264 |
National average reimbursement for CPT 17264 by major payers:
$223.71
$255.89
$257.03
$335.64
| 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 17264 | ||||||
United | 17264 | $665.00 | 1194935577 - MILLENNIUM SURGICAL CENTER LLC | 205225327 - (NJ) MILLENNIUM SURGICAL CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $200.00 | 1093295545 - SURGERY CENTER 121 LLC | 831195079 - (TX) SURGERY CENTER 121 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $566.00 | 1972869881 - ADVANCED SURGERY CENTER OF BETHESDA, LLC | 454376136 - (MD) ASC BETHESDA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $147.00 | 1558003764 - NORTH CHAPEL HILL SURGERY CENTER LLC | 463242402 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $168.00 | 1053597161 - 1800 MCDONOUGH ROAD SURGERY CENTER LLC | 261278011 - (IL) 1800 MCDONOUGH ROAD SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $84.00 | 1629409578 - PAIN CENTER OF WYOMING VALLEY, LLC | 462023592 - (PA) PAIN CENTER OF WYOMING VALLEY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $346.00 | 1457306888 - PMTC SURGERY CENTER, INC | 731651884 - (WI) PMTC SURGERY CENTER INC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $65.00 | 1972147239 - CHILDREN'S SURGERY CENTER OF PHILADELPHIA LLC, CHILDREN'S DENTAL SURGERY OF PHILADELPHIA | 842886610 - (PA) CHILDRENS SURGERY CENTER OF PHILADELPHIA LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $84.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $200.00 | 1376194431 - ASCENT SURGERY CENTER LLC | 823347568 - (TX) ASCENT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $574.00 | 1881905792 - SURGCENTER PINELLAS, LLC | 271372259 - (FL) SURGCENTER PINELLAS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $970.00 | 1174587984 - ST MARKS AMBULATORY SURGERY ASSOCIATES LP, MT. OLYMPUS SURGERY CENTER | 621449273 - (UT) ST MARKS AMBULATORY SURGERY ASSOCIATES LP | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $531.00 | 1891257473 - WESTGATE SURGERY CENTER, LLC, WESTGATE SURGERY CENTER | 352651945 - (AZ) WESTGATE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $200.00 | 1609223056 - HEART HEALTH CENTER, LLC | 473280746 - (AZ) HEART HEALTH CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17264 | $500.00 | 1144516451 - CPMSC GWINNETT, LLC | 274810320 - (GA) CPMSC GWINNETT LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 17264 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 17264 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 17264 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 |
| 17264-CPT | Moderate | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter 3.1 To 4.0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 17264. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 17264 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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