CPT 17272
Global 010 ActiveDstr mal les s/n/h/f/g 1.1-2
CPT 17272 Billing & Documentation Guide
CPT code 17272 (Dstr mal les s/n/h/f/g 1.1-2) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.77, a non-facility practice expense RVU of 3.54, and a malpractice RVU of 0.18, a total non-facility RVU of 5.49 and facility RVU of 3.04. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $188.87, though rates vary from $163.78 to $239.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 17272, 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 17272 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 5 units of 17272 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 17272
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.77 | 1.77 |
| Practice Expense RVU | 3.54 | 1.09 |
| Malpractice RVU | 0.18 | 0.18 |
| Total RVU | 5.49 | 3.04 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 17272
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 | $204.41 | $107.58 | $192.94 - $239.35 | 29 |
| Florida | $189.46 | $107.35 | $181.19 - $197.41 | 3 |
| Georgia | $179.2 | $101.14 | $171.76 - $186.65 | 2 |
| Illinois | $185.07 | $106 | $176.47 - $192.16 | 4 |
| Michigan | $178.61 | $101.77 | $173.86 - $183.36 | 2 |
| North Carolina | $173.28 | $96.93 | $173.28 - $173.28 | 1 |
| New York | $202 | $110.71 | $175.67 - $214.65 | 5 |
| Ohio | $173.13 | $98.42 | $173.13 - $173.13 | 1 |
| Pennsylvania | $181.89 | $101.74 | $173.34 - $190.44 | 2 |
| Texas | $181.44 | $100.87 | $172.3 - $189.66 | 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 17272
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 17272 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 17272
What does CPT code 17272 mean? +
CPT code 17272 represents: Dstr mal les s/n/h/f/g 1.1-2. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 17272? +
The 2026 Medicare national average non-facility payment for CPT 17272 is $188.87. Rates range from $163.78 to $239.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 17272? +
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 17272? +
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 June 1, 2026.
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