CPT 17266
Global 010 ActiveDstrj mal les t/a/l >4.0 cm
CPT 17266 Billing & Documentation Guide
CPT code 17266 (Dstrj mal les t/a/l >4.0 cm) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.33, a non-facility practice expense RVU of 4.34, and a malpractice RVU of 0.23, a total non-facility RVU of 6.9 and facility RVU of 3.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $237.28, though rates vary from $206.3 to $299.53 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 17266, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 17266 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 17266 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 17266
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.33 | 2.33 |
| Practice Expense RVU | 4.34 | 1.26 |
| Malpractice RVU | 0.23 | 0.23 |
| Total RVU | 6.9 | 3.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 17266
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $256.31 | $134.58 | $242.14 - $299.53 | 29 |
| Florida | $238.22 | $135 | $227.95 - $248.16 | 3 |
| Georgia | $225.43 | $127.28 | $216.29 - $234.56 | 2 |
| Illinois | $232.85 | $133.44 | $222.18 - $241.68 | 4 |
| Michigan | $224.76 | $128.16 | $218.85 - $230.66 | 2 |
| North Carolina | $217.98 | $122 | $217.98 - $217.98 | 1 |
| New York | $253.68 | $138.91 | $220.94 - $269.43 | 5 |
| Ohio | $217.92 | $123.99 | $217.92 - $217.92 | 1 |
| Pennsylvania | $228.73 | $127.96 | $218.16 - $239.29 | 2 |
| Texas | $228.1 | $126.82 | $216.87 - $238.15 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 17266
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 17266 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 17266
What does CPT code 17266 mean? +
CPT code 17266 represents: Dstrj mal les t/a/l >4.0 cm. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 17266? +
The 2026 Medicare national average non-facility payment for CPT 17266 is $237.28. Rates range from $206.3 to $299.53 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 17266? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 17266? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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