Is Mohs surgery for skin cancer covered by insurance?
Usually yes, once a biopsy has confirmed skin cancer. Code 17311 covers the first round of Mohs, where the surgeon takes the cancer out one thin layer at a time and reads each layer under a microscope during the same visit. Most plans pay for it, some want approval first, and the closure and follow up bill as their own lines.
Usually
Covered for confirmed skin cancer
Stage by stage
17311 is the first stage on the head, neck, hands, feet, genitals, or another high risk site. Every further stage that day adds a 17312 line.
Surgeon reads it
The Mohs surgeon has to read the slides as well as operate. If an outside pathologist bills that same tissue, the Mohs lines get denied.
Approval first
Some plans require prior authorization, and some apply appropriate use rules that question Mohs for a low risk spot on the trunk.
Biggest quote
Mohs plus repair is the largest number a dermatology desk quotes. One check first returns plan status, deductible left, and any prior authorization flag the payer reports.
What would a real check show for this patient's 17311?
Pick a sample plan and type your per-stage fee. This is the visibility a real-time check gives the desk for every actual patient, in under a second.
Eligibility readout · 17311
Sample- Coverage
- Active, no prior authorization flag returned
- Frequency
- No limit, prior authorization not required
- Patient share
- Type your fee to see it
Estimate from a sample plan. A real check reads the actual plan in under a second.
When 17311 is the right code
- Skin cancer confirmed by a biopsy first
- Head, neck, hands, feet, genitals, or high risk site
- The same surgeon also reads the slides
- First stage of the day, up to five tissue blocks
Documentation payers expect
Payers want the pathology report that confirmed the cancer, the number of stages and tissue blocks, and a map of the site. Plans that apply appropriate use rules also expect the reason Mohs was chosen over a standard excision.
Why Mohs claims get denied
What happens after Mohs
The wound still has to be closed, and the closure is its own line: layered stitching, a skin flap (14040), or a graft, each with a separate patient share. Visits inside the global period are reported as 99024 at no charge, which patients need to hear up front. If the margins were not clear, another session follows. Checking the plan, the deductible left, and the prior authorization flag before the date turns a four figure day into a number the patient already agreed to.
17311, quick answers
Does insurance cover Mohs surgery?
Most plans cover it once a biopsy has confirmed skin cancer and the site or tumor type fits the plan's rules. Some require approval before the date.
Why is there a second charge for the closure?
Mohs pays for removing the cancer. Closing the wound is a separate code, such as 13132 or 14040, with its own patient share.
Does Medicare cover Mohs?
Yes for confirmed skin cancer, and Medicare expects the same doctor to perform the surgery and read the slides. The patient owes 20% after the Part B deductible.
Will I be billed for each stage?
The first stage is 17311 and each further stage that day adds 17312. Two or three stages in one visit is common.
Do I need prior authorization?
Some plans require it and some do not. An eligibility check flags prior authorization where the payer reports it, so ask before scheduling.
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Related: 17312 · 17313 · 11602
CPT is a registered trademark of the American Medical Association. This page is Valian's own plain-English summary for front-desk teams, not official CPT descriptor text, and is not billing or clinical advice. Coverage patterns are common plan behaviors; every plan differs. Verify benefits before the visit.