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Headline: CPT 17314: Mohs Micrographic Surgery for Trunk, Arms, and Legs — Clinical and Billing Overview
Lead: CPT 17314 defines the Mohs micrographic technique for removal and microscopic examination of skin tumors located on the trunk, arms, or legs. The code bundles surgical excision, specimen mapping and color coding, and intraoperative histologic preparation and examination by the surgeon, making it central to specialized dermatologic cancer care.
What the code represents and why it matters: Mohs surgery, captured by CPT 17314, is a tissue-sparing, margin-controlled approach widely used for certain skin cancers. Its procedural complexity, combined surgical-pathologic workflow, and variable site-of-service settings influence clinical staffing, documentation, and payer coverage considerations nationally.
Key payers covered: The analysis considers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: Readers will find a concise explanation of the procedure components and typical care settings, a summary of payer coverage considerations, comparisons to adjacent Mohs codes, and operational elements that commonly affect billing and claims processing. The publication highlights common clinical contexts for use and identifies where input was not available.
Limitations: Data not available in the input for specific utilization rates, site-level reimbursement benchmarks, and jurisdictional policy variations.
CPT 17314 describes the Mohs micrographic technique for complete tumor removal and microscopic examination of tissue from the trunk, arms, or legs. The code encompasses surgical excision of all gross tumor, preparation and mapping of specimens, color coding, and microscopic examination by the surgeon with routine histopathologic stains (for example, hematoxylin and eosin or toluidine blue).
Service Type: Dermatology / Mohs Micrographic Surgery
Typical Site of Service: Office (POS 11), Inpatient Hospital (POS 21), Outpatient Hospital (POS 22), Ambulatory Surgery Center (POS 24), Independent Clinic (POS 49), FQHC (POS 50), Public Health Clinic (POS 71), Rural Health Clinic (POS 72)
A 68-year-old patient presents to a dermatology clinic with a biopsy-proven basal cell carcinoma on the forearm. The patient is scheduled for Mohs micrographic surgery to achieve tissue-sparing excision with immediate microscopic margin evaluation. The clinical workflow: pre-procedure evaluation and consent are completed in the office; local anesthesia is administered; the surgeon performs staged excisions, maps and color-codes specimens, and examines frozen sections microscopically in the on-site lab. Stages continue until clear margins are confirmed. Reconstruction of the defect is performed in the same encounter when indicated. Typical sites of service include Office (POS 11), Inpatient Hospital (POS 21), Outpatient Hospital (POS 22), Ambulatory Surgery Center (POS 24), Independent Clinic (POS 49), FQHC (POS 50), Public Health Clinic (POS 71), and Rural Health Clinic (POS 72).
Modifiers
59 - DISTINCT PROCEDURAL SERVICE: used to indicate the Mohs procedure was distinct or independent from other services performed on the same day (for example, a separate unrelated surgical procedure on a different anatomic site performed on the same day).
Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
207ND0900X | Dermatology Physician |
207NS0135X | MOHS-Micrographic Surgery Physician |
207N00000X | Dermatopathology Physician |
C43.111 - Malignant melanoma of skin of lip, right upper eyelid, etc. ( (example diagnosis codes added in LCD revisions)
Clinical relevance: Malignant melanoma on a cutaneous site may be managed with Mohs micrographic surgery in select cases where margin control and tissue conservation are priorities.
C44.1121 - Basal cell carcinoma of skin of right upper eyelid, including ear, etc.
Clinical relevance: Basal cell carcinoma is a common indication for Mohs micrographic surgery to achieve complete excision with maximal tissue preservation, particularly in cosmetically or functionally sensitive areas.
| CPT Code | Description |
|---|---|
17313 | Mohs micrographic technique ... of the trunk, arms, or legs |
17315 | Mohs micrographic surgery add-on code for additional blocks beyond first five |
17313 is a closely related primary Mohs code used for procedures on the trunk, arms, or legs and represents the base category for stage-based Mohs excisions. 17313 is in the same family as the primary code and may be reported based on the anatomic site and stage details.
17315 is an add-on code reported in conjunction with the primary Mohs code to reflect additional tissue blocks processed beyond the first five blocks during the same Mohs session. 17315 is commonly used together with the primary Mohs code when the number of blocks exceeds the base allowance.
Medicare mean allowed rate ($400.10) sits near the middle of the national commercial averages: it is slightly lower than the BUCA (all commercial) mean ($405.89) and notably lower than UnitedHealth Group ($526.56) and Cigna ($472.42). Blue Cross Blue Shield and Aetna are below Medicare on average, with means of $379.50 and $349.46 respectively.
Dispersion measured as the interquartile range (P75 − P25) varies across payers. UnitedHealth Group shows the widest spread (approximately $291.00), followed by Cigna (about $262.75) and Blue Cross Blue Shield (about $186.00). Medicare is among the tightest (about $43.00), with Aetna and BUCA also relatively tighter than the largest commercial payers (Aetna about $125.25; BUCA about $195.39). The table and chart below present the full breakdown.
State: AK1 / 50
Alaska's reimbursement rates for CPT code 17314 are notably higher than national averages across all major payers. The mean rates for commercial payers such as Aetna, Blue Cross Blue Shield, Cigna, UnitedHealth Group, and BUCA are substantially above their respective national benchmarks, with Aetna's mean rate in Alaska exceeding $1,200 compared to a national mean of just over $349. This pattern is consistent across the board, highlighting Alaska as a high-reimbursement state for this procedure.
The rate spread, calculated as the difference between the 75th and 25th percentiles, varies by payer. Aetna shows no spread, indicating uniformity in rates, while Blue Cross Blue Shield and Cigna display wider spreads ($389.33 and $415.38, respectively), suggesting more variability in negotiated rates. The table and chart below present the full breakdown of payer-specific rates in Alaska for CPT code 17314.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.