Frequently Asked Questions

Reimbursements are $100-$250 or more depending on where the lesion is located on the body. (i.e. venereal lesions have much higher return rates)

With only a few treatments, your Verruca-Freeze® canister will pay for itself!

New users should start out with a Kit, which includes all training materials as well as a full set of CryoCones® and CryoBuds®. Replacement Canisters may be purchased subsequently at a lower cost.

Select a Verruca-Freeze® canister size based on the number of lesions you would like to treat. See FAQ #7 for a breakdown of freezes per canister. Keep in mind that the number of freezes per canister will vary depending on the size of the lesions you treat.

For high volume users, such as Podiatrists, we recommend purchasing our larger packs of canisters – the VFL200R and VFL300R.

The most recent cryosurgery textbooks state that -50°C is adequate to treat most benign skin lesions. Verruca-Freeze® delivers freezing temperatures of -70°C (-94°F), exceeding the minimum recommended freezing temperatures.

The FDA has cleared Verruca-Freeze® for removal of 21 types of lesions including: warts, plantar warts, venereal warts (condyloma acuminatum), seborrheic and actinic keratoses, achrochordon (skin tags), molluscum contagiosum, age spots, dermatofibroma, small keloids, granuloma annulare, porokeratosis plantaris, angiomas, lentigo maligna, keratoacanthoma, lentigo discreta, chondrodermatitis, epithelial nevus, leukoplakia and pyogenic granuloma. See our Treatable Lesions page for lesion descriptions.

The number of freezes per canister will depend on the size and severity of lesions treated. Here is a summary of the amount of freezes you can expect on average from your canister of Verruca-Freeze®:

Some factors that determine the amount of freezes you will utilize in a canister of cryogen:

• The size and severity of lesions treated (e.g. large plantar warts)
• The amount of times the Double-Freeze-Thaw method is employed
• The amount of pressure applied to the trigger when spraying

Some physicians increase the number of lesions they treat successfully by combining chemical treatment with cryosurgery. They use salicylic acid after cryo to treat difficult plantar warts and podophyllum after cryo to treat small, invisible venereal warts.

Verruca-Freeze® has two methods of application: CryoCones®, available in five sizes (3mm, 5mm, 7mm, 9mm, 12mm), and CryoBuds®, available in three sizes (small, medium, and large).

CryoBuds® are convenient for treating hard-to-reach or bony areas of the body. They are also recommended for treatment in sensitive areas such as the head, neck, or genitals. CryoBuds® are disposable. They can be used more than once on the same patient, but are not interchangeable between patients.

CryoCones® are intended for use on fleshy tissue areas where a tight seal can be achieved. They should NOT be used on the head, face, or neck. CryoCones® are reusable and should be soaked in bactericidal solution for sterilization. CryoCones® can also be autoclaved on the lowest setting if desired.

Verruca-Freeze® should never be applied without the use of a CryoBud® or CryoCone®. NEVER open spray the cryogen directly onto skin.

The selection of application method is usually the physicians preference, however our recommendations are as follows:

CryoBuds® are recommended for use when treating hard-to-reach or bony areas of the body, sensitive areas (such as the head, face, neck, and gentiles), hands, thin skin areas, and when treating small children.

CryoCones® are recommended for use on fleshy tissue areas where a tight seal can be achieved.

Verruca-Freeze® has an indefinite shelf life due to its positive shut off valve within the nozzle that prevents leakage and evaporation.

Verruca-Freeze® canisters should be stored at room temperature and should not be subjected to temperatures over 120°F. Canisters must also be kept out of direct sunlight. We recommend storing your canister in its original box and placed in an enclosed cabinet.

Spray time is approximately 3 to 6 seconds. When using the CryoCones®, accumulate approximately 1/8th inch (3mm) of cryogen into the cone. When using the CryoBud®, saturate the bud to its first drip point.

Freeze time varies depending on the size, type, and depth of the lesion. Freeze time is approximately 20-30 seconds. Allow a thaw time of approximately 40 seconds. We recommend the Double Freeze-Thaw method on lesions greater than 7mm and plantar warts.

After watching our Training Video, studying the instruction manual, and practicing on the practice pad provided with each kit, you should be able to quickly grasp how much of the cryogen to spray. Freeze and thaw times are important in order to achieve success in effectively treating lesions with Verruca-Freeze®

If you feel you have sprayed too much cryogen into the CryoCone®, let the cryogen spill to the floor, then remove the cone and place your hand on the lesion to stop the freeze cycle.

Always protect the eyes and ears when performing cryosurgery.

Use the 17000 series of CPT codes for destruction of lesions. Some lesions, such as venereal warts are coded by the lesion’s location. Reimbursement varies among insurance carriers and different areas of the country.

See our CPT Codes for detailed reimbursement rates.

Typically, veterinarians charge a fee of $50-$75 per treatment without anesthesia. If anesthesia is required, the fees range from $150-$200. If there are multiple lesions to be treated on one patient, some veterinarians will charge a flat fee for the first lesion ($50), and a minimal fee ($10-$12) for each additional lesion.

Contact Cryosurgery, Inc. at (615) 354-0414 or info@cryosurgeryinc.com. The National Procedures Institute in Midland, Michigan teaches courses in dermatologic procedures using Verruca-Freeze®, offering classes in different U.S. cities. Contact NPI at (800) 462-2492 or at The National Procedures Institute website. The AAFP and the AAPA also conduct dermatology workshops at their annual meetings.

In addition to our Double Freeze Thaw method, a technique called ballooning is often used. This is often used by podiatrists treating plantar warts and veterinarians treating sarcoids on large animals. This technique involves injecting lidocaine with epinephrine beneath the lesion. This injection does two things. First, it seperates the lesion from the blood supply, and second, it causes vaso constriction of the blood vessels which reduces the heat sink and allows the freeze to penetrate deeper and last longer. By doing this you are separating the lesion from the blood supply which allows the ice ball to penetrate deeper.

No, there are no HAZMAT fees associated with Verruca Freeze®.

No.

On approval of the Montreal Protocol set into motion to ban all CFCs (Chlorofluorocarbons) production in any form and was ratified by 196 countries. The terms call for zero production of CFCs in the world by 1996. The United States stopped production in 1990.

Any use of CFCs would be considered a violation of the world-wide agreement to ban production and use of Chlorofluorocarbons.

http://en.wikipedia.org/wiki/Montreal_Protocol

http://www.epa.gov/ozone/intpol/index.html

http://www.answers.com/topic/montreal-protocol

According to CDC guidelines, CryoCones® are classified as a non-critical medical device and may be disinfected using an EPA registered intermediate-level or low-level disinfectant. CaviCide® or CaviWipes™ by Metrex are highly recommended. Please follow the directions provided by the disinfectant manufacturer.

CryoCones® can also be autoclaved on the plastics setting if desired. Refer to autoclave instructions for plastics specifications. Caution: Autoclaving CryoCones® may reduce their shelf life.

Although some of our customers go many years without purchasing a new kit, we highly encourage the purchase of additional kits if you wish to treat patients in different exam rooms or at different offices so you will have all the CryoCones® and CryoBuds® readily available.

It is also our recommendation to purchase a new kit every 3 to 5 canister uses to receive additional cones and bud applicators as well as updated educational and instruction materials. 

When treating a high volume of lesions we recommend using our 100 Freeze Canister (VFL100) filled with 236ml of cryogen. This product offers an extremely low cost per treatment.

If you are interested in lowering your cost per freeze even more, try our 200 Freeze Twin Pack (VFL200R) or 300 Freeze Triple Pack (VFL300R). Both the Twin and Triple Packs are ideal for large clinics or those treating over 100 lesions a month.

Often, multiple superficial lesions (such as skin tags) can be treated with a fully charged medium and large CryoBud®, which can dramatically increase the number of freezes per canister.

Nitrous oxide can also be used for cryosurgery and is usually applied with a cryoprobe. To use nitrous oxide a physician must have a gas cylinder, a regulator, a pressure gauge, and a cryogun with assorted tips. While the gas does not evaporate like liquid nitrogen, the cost of the basic tank, without the probes can be between $2,000 and $4,000 with the probes averaging $350 – $400 each. When the tank is empty a refill can run from $75 to $200 a month, plus delivery charges.

Nitrous oxide is a known teratogen. In addition, because of studies done on health care professionals showing adverse health consequences, OSHA requires that all nitrous oxide systems be vented directly outside. This is not practical in many office situations.

Verruca-Freeze®

• 6+ years shelf life
• Cost per freeze: [cpf_range]
• 4 different canister sizes available
• Number of freezes per canister: 40 – 100, depending on canister size
• Freezing time: 20 – 40 seconds
• Can treat multiple lesions on the same patient with CryoBuds®

CryOmega®

• 6 month shelf life once activated
• Cost per freeze: $14.17 – $21.25
• 240 seconds spray time
• 10 – 15 seconds spray per lesion
• 16 – 24 treatments per Unit

CryoProbe®

• Shelf life: “weeks” after punctured
• Warranty: unknown
• 120 seconds of freeze time (8g Cartridge)
• 10 – 15 second spray per lesion
• Upfront Cost of $2,995 for the X Starter Kit
  • Assume:
    • 3 year life span
    • Average of 100 lesions treated per year
  • Cost Per Treatment (not including the cartridge)
    • 6 mos – 50 lesions: $60 per lesion
    • 1 yrs – 100 lesions: $30 per lesion
    • 2 yrs – 200 lesions: $15 per lesion
    • 3 yrs – 300 lesions: $10 per lesion

While these methods of removing a lesion are effective, they are also time consuming and produce medical wastes and/or an unpleasant odor. With Verruca-Freeze®, the procedure takes less than one minute, there is no medical waste, no anesthetic is required, an assistant is not required, and no bandages are needed. The medical staff is not exposed to HIV or Hepatitis B viruses.

Your average cost-per-freeze is [cpf_range]. If you factor in your time and your staff time into the surgical equation, you can see that scalpel surgery or electrocautery cost much more but both methods are generally reimbursed at or nearly the same rate as cryosurgery.

1. Make sure patient is properly positioned and cone is pressed firmly, covering the lesion.
2. Gently spray to fill cone a minimum of 1/8th inch (1/4 inch for 3mm or 5mm cones).
3. Evaporation time should be at least 30 seconds.
4. Thaw time ideally is between 35 to 40 seconds.
5. After complete thawing, repeat freeze thaw cycle if there is any doubt about under freezing.

1. Buds can be used anywhere on the body, but especially should be used on the face and neck.
2. Gently press the trigger to slowly saturate the bud completely, until the first drip.
3. After saturation, wait 15 to 20 seconds for complete ice crystalization to form inside the bud before application. This is a critical step because the bud temperature will fall an additional 3 to 6 degrees by waiting 15 to 20 seconds.
4. Press bud firmly to the lesion for 30 to 40 seconds to form a good ice ball.
5. Remove the bud and allow the lesion to slowly thaw 30 to 40 seconds. Touching the lesions before the thaw is complete can cancel the effect of the freeze.