CPT 17266 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 17266 |
National average reimbursement for CPT 17266 by major payers:
$251.92
$291.78
$291.85
$382.11
| 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 17266 | ||||||
United | 17266 | $566.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $67.00 | 1053835058 - CEI PHYSICIANS PSC LLC, CVP SURGERY CENTER | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $147.00 | 1417935206 - DIGESTIVE DISEASE CENTER, LP, MEMORIAL CARE DIGESTIVE CARE CENTER SADDLEBACK MEMORIAL, AN AFFILIATE | 330292435 - (CA) DIGESTIVE DISEASE CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $737.00 | 1982667499 - CLEAR LAKE SURGICARE, LTD | 621600411 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $158.00 | 1053508077 - JOURNEY LITE OF CINCINNATI, LLC | 208861350 - (OH) JOURNEYLITE OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $203.00 | 1972055382 - ALLIANCE SURGERY PARTNERS, LLC | 901108673 - (CA) ALLIANCE SURGERY PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $85.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $1125.00 | 1295381572 - SOUTH SUBURBAN SURGICAL SUITES, LLC, SOUTH SUBURBAN SURGICAL SUITES | 842207819 - (IN) SOUTH SUBURBAN SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $60.00 | 1396454963 - ST LUKES SURGICAL CENTER INC, ST. LUKE'S SURGICAL AT WESLEY CHAPEL | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $541.00 | 1558390781 - BAPTIST-PHYSICIANS SURGERY CENTER | 43665929 - (KY) BAPTIST-PHYSICIANS SURGERY CENT | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $566.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $83.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $79.00 | 1154555472 - GEORGIA RETINA SURGERY CENTER, LLC | 262303683 - (GA) GEORGIA RETINA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $688.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 17266 | $250.00 | 1326132291 - MADISON STREET SURGERY CENTER, LLC | 841499650 - (CO) MADISON STREET SURGERY CENTER LLC | CO | 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 17266 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 17266 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 17266 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 |
| 17266-CPT | Moderate | Destruction, Malignant Lesion (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms Or Legs; Lesion Diameter Over 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 17266. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 17266 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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