CPT 17286
Global 010 ActiveDstr mal ls f/e/e/n/l/m>4.0
CPT 17286 Billing & Documentation Guide
CPT code 17286 (Dstr mal ls f/e/e/n/l/m>4.0) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.37, a non-facility practice expense RVU of 5.71, and a malpractice RVU of 0.46, a total non-facility RVU of 10.54 and facility RVU of 6.72. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $361.14, though rates vary from $317.7 to $445.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 17286, 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 17286 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 17286 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 17286
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.37 | 4.37 |
| Practice Expense RVU | 5.71 | 1.89 |
| Malpractice RVU | 0.46 | 0.46 |
| Total RVU | 10.54 | 6.72 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 17286
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 | $385.2 | $234.22 | $365.71 - $445.27 | 29 |
| Florida | $367.23 | $239.21 | $351.38 - $383.36 | 3 |
| Georgia | $346.51 | $224.79 | $334.4 - $358.62 | 2 |
| Illinois | $360.12 | $236.83 | $344.1 - $373.92 | 4 |
| Michigan | $346.67 | $226.86 | $337.43 - $355.91 | 2 |
| North Carolina | $333.72 | $214.68 | $333.72 - $333.72 | 1 |
| New York | $386.54 | $244.2 | $337.95 - $410.6 | 5 |
| Ohio | $335.58 | $219.08 | $335.58 - $335.58 | 1 |
| Pennsylvania | $350.51 | $225.53 | $335.56 - $365.46 | 2 |
| Texas | $348.8 | $223.19 | $333.79 - $361.65 | 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 17286
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 17286 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 17286
What does CPT code 17286 mean? +
CPT code 17286 represents: Dstr mal ls f/e/e/n/l/m>4.0. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 17286? +
The 2026 Medicare national average non-facility payment for CPT 17286 is $361.14. Rates range from $317.7 to $445.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 17286? +
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 17286? +
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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