CPT code 17003: Actinic keratosis destruction, lesions 2-14, each additional2026 Medicare rate & RVUs in Napa, CA

Report this add-on once per additional premalignant skin lesion, typically an actinic keratosis, when two through fourteen are destroyed in one session.

CMS RVU26DEffective Oct 1, 2026One payment locality19.9M Medicare services in 2024

In Napa, CA, Medicare pays $8.02 for 17003 in the office and $1.86 when it’s performed in a hospital or facility.

$8.02Office (non-facility)
$1.86Hospital or facility
+26.3%vs the national office rate ($6.35)

Check a contract rate as a % of Medicare · 17003 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 17003 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Napa, CA
  2. What 17003 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 17003 covers

This code captures destruction of additional premalignant skin lesions, most commonly actinic keratoses, after the first lesion has been treated in the same session. Dermatologists, primary care physicians, nurse practitioners, and physician assistants usually perform it in the office. Liquid nitrogen cryosurgery is the typical method, though curettage, electrosurgery, chemical destruction, and laser also qualify. Patients with sun-damaged skin on the face, scalp, ears, forearms, and backs of the hands often have several lesions treated at one visit, which is why this is among the highest-volume codes Medicare pays.

Report the first lesion with 17000, then report one unit of 17003 for each additional premalignant lesion from the second through the fourteenth, for a maximum of 13 units. When 15 or more premalignant lesions are treated, use 17004 alone instead of 17000 and 17003. Documentation should state the lesion count, anatomic locations, clinical diagnosis, and destruction method. CMS designates 17003 as an add-on code: it is billed only with its primary procedure and paid within that procedure's global period.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Napa, CA compares for 17003

Across 109 of 109 payment localities, the office rate for 17003 runs from $5.64 in Arkansas to $8.71 in Santa Clara County, CA. Napa, CA pays $8.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

17003 in Napa, CA vs other payment areas
  1. Napa, CA · this page$8.02
  2. Bakersfield, CA · California$6.85−$1.17
  3. Chico, CA · California$6.85−$1.17
  4. El Centro, CA · California$6.85−$1.17
  5. Fresno, CA · California$6.85−$1.17
  6. Hanford, CA · California$6.85−$1.17
  7. Los Angeles, CA · California$7.32−$0.70

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

17003 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$6.85$1.72
Merced, CACalifornia$6.85$1.72
Modesto, CACalifornia$6.85$1.72
Oxnard, CACalifornia$7.30$1.77
Redding, CACalifornia$6.85$1.72
Rest of CaliforniaCalifornia$6.85$1.72
Riverside, CACalifornia$6.85$1.73
Sacramento, CACalifornia$7.21$1.77

17003 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$5.64

$7.78

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
17003 office rate range by state
State / territoryOffice rate rangeLocalities
AK$7.341
AL$5.721
AR$5.641
AZ$6.191
CA$6.85–$8.7129
CO$6.681
CT$6.761
DC$7.311
DE$6.291
FL$6.13–$6.553
GA$5.81–$6.432
GU$7.031
HI$7.031
IA$5.921
ID$5.951
IL$5.91–$6.494
IN$5.981
KS$5.871
KY$5.791
LA$5.77–$6.052
MA$6.63–$7.372
MD$6.42–$7.313
ME$5.95–$6.302
MI$5.91–$6.172
MN$6.491
MO$5.65–$6.113
MS$5.651
MT$6.351
NC$6.011
ND$6.351
NE$5.961
NH$6.551
NJ$6.86–$7.232
NM$5.931
NV$6.351
NY$6.10–$7.385
OH$5.911
OK$5.811
OR$6.33–$6.922
PA$5.94–$6.582
PR$6.401
RI$6.541
SC$5.971
SD$6.351
TN$5.891
TX$5.90–$6.648
UT$6.051
VA$6.26–$7.312
VI$6.401
VT$6.301
WA$6.63–$7.552
WI$6.141
WV$5.691
WY$6.351

See 17003 in every payment locality

How the 17003 rate is calculated

Each of 17003’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 17003

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.04

0.04 RVUs× 1.000 GPCI

Practice expense0.15

0.15 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.1900

Conversion factor

$33.4009

Medicare rate

$6.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Napa, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,620

Code
17003
Physician work
0.04
Practice expense
0.15
Malpractice
0.00

GPCI2026.csv

17

Locality
Napa, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.508
Office calculation for 17003 in Napa, CA
ComponentRVULocality factorAdjusted
Physician work0.04× 1.0630.0425
Practice expense0.15× 1.3180.1977
Malpractice0.00× 0.5080.0000
Total RVUs0.2402
Conversion factor× 33.4009

Office rate, Napa, CA$8.02

Office: (0.04 × 1.063 + 0.15 × 1.318 + 0 × 0.508) × $33.4009 = $8.02

Facility: (0.04 × 1.063 + 0.01 × 1.318 + 0 × 0.508) × $33.4009 = $1.86

Open 17003 in the RVU calculator

Payment rules and modifiers for 17003

The CMS indicators that decide how 17003 is paid alongside other services.

CMS payment indicators · 17003

Actinic keratosis destruction, lesions 2-14, each additional

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 17003 has changed in Napa, CA

17003 · Office / nonfacility

$8.02

Effective 2026-10-01

The base rate is $0.13 lower than on 2025-10-01, moving from $8.15 to $8.02 (1.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $8.15changed to$8.02

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.16 changed to 0.15
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.521 changed to 0.508

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $8.39changed to$8.15

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $8.25changed to$8.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $8.28changed to$8.25

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.513 changed to 0.521
  5. January 1, 2023

    RVU23A

    $8.20changed to$8.28

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.513

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $7.84changed to$8.20

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.15 changed to 0.16

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $7.32changed to$7.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.13 changed to 0.15
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $6.67changed to$7.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.11 changed to 0.13
    • Malpractice RVU 0.01 changed to 0.00
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $6.21changed to$6.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.10 changed to 0.11

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $6.71changed to$6.21

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.11 changed to 0.10
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$6.71

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$8.02$1.86RVU26D
2026-07-01$8.02$1.86RVU26C
2026-04-01$8.02$1.86RVU26B
2026-01-01$8.02$1.86RVU26A
2025-10-01$8.15$2.22RVU25D
2025-07-01$8.15$2.22RVU25C
2025-04-01$8.15$2.22RVU25B
2025-01-01$8.15$2.22RVU25A
2024-10-01$8.39$2.28RVU24D
2024-07-01$8.39$2.28RVU24C
2024-04-01$8.39$2.28RVU24B
2024-03-09$8.39$2.28RVU24AR
2024-01-01$8.25$2.24RVU24A
2023-10-01$8.28$2.28RVU23D
2023-07-01$8.28$2.28RVU23C
2023-04-01$8.28$2.28RVU23B
2023-01-01$8.28$2.28RVU23A
2022-10-01$8.20$2.29RVU22D
2022-07-01$8.20$2.29RVU22C
2022-04-01$8.20$2.29RVU22B
2022-01-01$8.20$2.29RVU22A
2021-10-01$7.84$2.31RVU21D
2021-07-01$7.84$2.31RVU21C
2021-04-01$7.84$2.31RVU21B
2021-01-01$7.84$2.31RVU21A
2020-10-01$7.32$2.41RVU20D
2020-07-01$7.32$2.41RVU20C
2020-04-01$7.32$2.41RVU20B
2020-01-01$7.32$2.41RVU20A
2019-10-01$6.67$2.59RVU19D
2019-07-01$6.67$2.59RVU19C
2019-04-01$6.67$2.59RVU19B
2019-01-01$6.67$2.59RVU19A
2018-10-01$6.21$2.59RVU18D
2018-07-01$6.21$2.59RVU18C
2018-04-01$6.21$2.59RVU18B
2018-01-01$6.21$2.59RVU18AR1
2017-10-01$6.71$2.60RVU17D
2017-07-01$6.71$2.60RVU17C
2017-04-01$6.71$2.60RVU17B
2017-01-01$6.71$2.60RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 17003 for an earlier date of service

Where the Napa, CA rate applies

Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in California

17003 billing questions

How many units of 17003 can be reported?

Report one unit per premalignant lesion from the second through the fourteenth, or 1 to 13 units alongside one unit of 17000. Treating 15 or more premalignant lesions shifts reporting to 17004 alone.

Can 17003 be reported with 17004?

No. When 15 or more premalignant lesions are destroyed in a session, 17004 covers the entire count and replaces both 17000 and 17003.

Is 17003 billable without 17000?

No. It is an add-on reported with 17000 for the first premalignant lesion treated in the same session.

Can an E/M visit be billed on the same day as 17000 and 17003?

Yes, if documentation supports a significant, separately identifiable E/M service beyond the usual evaluation and decision to destroy the lesions. Append modifier 25 to the E/M code; a different diagnosis is not required.

Does 17003 apply to warts or seborrheic keratoses?

No. It covers premalignant lesions such as actinic keratoses. Destruction of benign lesions such as warts or seborrheic keratoses is reported with 17110 or 17111 according to the benign lesion count.

What documentation supports the unit count?

The note should list the number of lesions treated, their body sites, the premalignant diagnosis, and the destruction method used, so the units tie directly to the record.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 17003PPRRVU2026_Oct_nonQPP.csv, line 1,620 (RVU26D)
Geographic factors for Napa, CAGPCI2026.csv, line 17 (RVU26D)

Open CMS sourceHow we calculate rates

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