Item Brochure

Indication
CPT
Code*
Non–Facility
Medicare
Reimbursement
3
Estimated Level
of Reimbursement/Kit
(36 application) (70 application)
Acrochordon
(Skin Tags)
11200 $70.28 $2,530.08 $4,919.60
Actinic 17000 $52.78 $1,900.08 $3,694.60
Common Warts 17110 $88.06 $3,170.16 $6,164.20
Flat Warts 17110 $88.06 $3,170.16 $6,164.20
Genital Warts
(Male)
54056 $113.74 $4,094.64 $7,961.80
Genital Warts
(Female)
56501 $104.99 $3,779.64 $7,349.30
Lentigo 17110 $88.06 $3,170.16 $6,164.20
Molluscum 17110 $88.06 $3,170.16 $6,164.20
Plantar Warts 17110 $88.06 $3,170.16 $6,164.20
Seborrheic
Keratosis
17110 $88.06 $3,170.16 $6,164.20
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* The CPT codes listed are represented of the principal codes used for cryotherapeutic treatment for each
indication. Additional codes may apply for extensive treatments and multiple lesions. Payments will vary
based on geographical location, payor type, facility/non-facility, and other factors. Please consult with your
local payor group for specic reimbursement schedules.
Reimbursement amounts are based on the proposed conversion factor $28.2239 effective 4/1/2015 as
published in the Federal Register, Vol. 79, No. 219, November 13, 2014.
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