CPT 17000: Destruction, premalignant lesion, 1st
What this code means, what it should cost, and how to dispute an overcharge.
Fair Price Reference
What is CPT 17000?
CPT 17000 (Destruction, premalignant lesion, 1st) is a dermatology billing code defined by the American Medical Association. It's used to bill your insurance or you directly for this service.
What CPT 17000 should cost
The Centers for Medicare & Medicaid Services (CMS) pays approximately $58 for CPT 17000 under the 2025 Physician Fee Schedule. This is what the federal government has determined is a reasonable payment for this service.
Private insurance typically pays 1.2–1.8x Medicare rates ($70–$104). Hospital chargemaster prices for CPT 17000 often range from $100 to $400 — a markup of 1.7x to 6.9x over Medicare.
Common overcharges on CPT 17000
Billing punch biopsy (11104) when a shave biopsy (11102) was performed. Billing destruction of benign lesions (17110) when the lesion qualifies as premalignant (17000).
About Dermatology billing
Dermatology procedures have precise CPT distinctions based on lesion size and body location. Small coding errors translate to large billing errors.
Request the procedure note. Verify biopsy type and lesion characteristics match the billed CPT code.
How to dispute a CPT 17000 overcharge
- Request the itemized bill. You are entitled to a detailed line-by-line bill showing every CPT code billed. Ask in writing.
- Compare to Medicare allowable. If the charge exceeds 150% of Medicare ($87), you have grounds to dispute.
- Request documentation. For E&M codes, ask for the visit note. For procedures, ask for the operative report. The documentation must justify the code billed.
- Send a formal dispute letter. Cite the specific discrepancy between the documentation and the code. Reference Medicare rates and NCCI edits where applicable.
- Follow up in writing. Give the provider 30 days to respond. If they don't, escalate to the state attorney general and insurance commissioner.
Got CPT 17000 on your bill?
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