CPT code 17003: Actinic keratosis destruction, lesions 2-14, each additional2026 Medicare rate & RVUs in North Dakota
Report this add-on once per additional premalignant skin lesion, typically an actinic keratosis, when two through fourteen are destroyed in one session.
In North Dakota, Medicare pays $6.35 for 17003 in the office and $1.67 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Dakota 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. North Dakota pays $6.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$6.35
- Los Angeles, CA · California$7.32+$0.97
- Washington, DC area · District of Columbia$7.31+$0.96
- Miami, FL · Florida$6.55+$0.20
- Chicago, IL · Illinois$6.38+$0.03
- Manhattan, NY · New York$7.24+$0.89
- Alaska · Alaska$7.34+$0.99
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $5.72 | $1.63 |
| ArkansasArkansas | $5.64 | $1.62 |
| ArizonaArizona | $6.19 | $1.66 |
| Bakersfield, CACalifornia | $6.85 | $1.73 |
| Chico, CACalifornia | $6.85 | $1.72 |
| El Centro, CACalifornia | $6.85 | $1.72 |
| Fresno, CACalifornia | $6.85 | $1.72 |
| Hanford, CACalifornia | $6.85 | $1.72 |
| Madera, CACalifornia | $6.85 | $1.72 |
| Merced, CACalifornia | $6.85 | $1.72 |
| Modesto, CACalifornia | $6.85 | $1.72 |
| Napa, CACalifornia | $8.02 | $1.86 |
| 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 |
| Salinas, CACalifornia | $7.18 | $1.76 |
| San Diego, CACalifornia | $7.37 | $1.78 |
| Marin County, CACalifornia | $8.53 | $1.93 |
| San Francisco, CACalifornia | $8.53 | $1.93 |
| San Benito County, CACalifornia | $8.71 | $1.96 |
| Santa Clara County, CACalifornia | $8.71 | $1.96 |
| San Luis Obispo, CACalifornia | $7.07 | $1.74 |
| Santa Cruz, CACalifornia | $7.45 | $1.77 |
| Santa Maria, CACalifornia | $7.22 | $1.76 |
| Santa Rosa, CACalifornia | $7.53 | $1.79 |
| Stockton, CACalifornia | $6.85 | $1.72 |
| Vallejo, CACalifornia | $8.02 | $1.86 |
| Visalia, CACalifornia | $6.85 | $1.72 |
| Yuba City, CACalifornia | $6.85 | $1.72 |
| ColoradoColorado | $6.68 | $1.71 |
| ConnecticutConnecticut | $6.76 | $1.72 |
| DelawareDelaware | $6.29 | $1.67 |
| Fort Lauderdale, FLFlorida | $6.41 | $1.67 |
| Rest of FloridaFlorida | $6.13 | $1.66 |
| Atlanta, GAGeorgia | $6.43 | $1.68 |
| Rest of GeorgiaGeorgia | $5.81 | $1.63 |
| Hawaii, Guam, HIHawaii | $7.03 | $1.72 |
| IowaIowa | $5.92 | $1.64 |
| IdahoIdaho | $5.95 | $1.64 |
| East St. Louis, ILIllinois | $5.95 | $1.64 |
| Rest of IllinoisIllinois | $5.91 | $1.64 |
| Suburban Chicago, ILIllinois | $6.49 | $1.69 |
| IndianaIndiana | $5.98 | $1.65 |
| KansasKansas | $5.87 | $1.64 |
| KentuckyKentucky | $5.79 | $1.63 |
| New Orleans, LALouisiana | $6.05 | $1.65 |
| Rest of LouisianaLouisiana | $5.77 | $1.63 |
| Metropolitan Boston, MAMassachusetts | $7.37 | $1.79 |
| Rest of MassachusettsMassachusetts | $6.63 | $1.71 |
| Baltimore area, MDMaryland | $6.73 | $1.72 |
| Rest of MarylandMaryland | $6.42 | $1.69 |
| Rest of MaineMaine | $5.95 | $1.64 |
| Southern Maine, MEMaine | $6.30 | $1.67 |
| Detroit, MIMichigan | $6.17 | $1.66 |
| Rest of MichiganMichigan | $5.91 | $1.64 |
| MinnesotaMinnesota | $6.49 | $1.68 |
| Metropolitan Kansas City, MOMissouri | $6.04 | $1.65 |
| Metropolitan St. Louis, MOMissouri | $6.11 | $1.65 |
| Rest of MissouriMissouri | $5.65 | $1.62 |
| MississippiMississippi | $5.65 | $1.62 |
| MontanaMontana | $6.35 | $1.67 |
| North CarolinaNorth Carolina | $6.01 | $1.65 |
| NebraskaNebraska | $5.96 | $1.64 |
| New HampshireNew Hampshire | $6.55 | $1.68 |
| Northern New JerseyNew Jersey | $7.23 | $1.81 |
| Rest of New JerseyNew Jersey | $6.86 | $1.75 |
| New MexicoNew Mexico | $5.93 | $1.64 |
| NevadaNevada | $6.35 | $1.67 |
| NYC suburbs and Long Island, NYNew York | $7.38 | $1.82 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $6.88 | $1.76 |
| Queens, NYNew York | $7.34 | $1.82 |
| Rest of New YorkNew York | $6.10 | $1.65 |
| OhioOhio | $5.91 | $1.64 |
| OklahomaOklahoma | $5.81 | $1.63 |
| Portland, OROregon | $6.92 | $1.73 |
| Rest of OregonOregon | $6.33 | $1.67 |
| Metropolitan Philadelphia, PAPennsylvania | $6.58 | $1.71 |
| Rest of PennsylvaniaPennsylvania | $5.94 | $1.64 |
| Puerto RicoPuerto Rico | $6.40 | $1.67 |
| Rhode IslandRhode Island | $6.54 | $1.71 |
| South CarolinaSouth Carolina | $5.97 | $1.64 |
| South DakotaSouth Dakota | $6.35 | $1.67 |
| TennesseeTennessee | $5.89 | $1.64 |
| Austin, TXTexas | $6.64 | $1.69 |
| Beaumont, TXTexas | $5.90 | $1.64 |
| Brazoria, TXTexas | $6.31 | $1.68 |
| Dallas, TXTexas | $6.34 | $1.68 |
| Fort Worth, TXTexas | $6.29 | $1.68 |
| Galveston, TXTexas | $6.32 | $1.68 |
| Houston, TXTexas | $6.32 | $1.68 |
| Rest of TexasTexas | $6.09 | $1.65 |
| UtahUtah | $6.05 | $1.65 |
| VirginiaVirginia | $6.26 | $1.66 |
| Virgin Islands, VIUnited States Virgin Islands | $6.40 | $1.67 |
| VermontVermont | $6.30 | $1.67 |
| Rest of WashingtonWashington | $6.63 | $1.71 |
| King County, WAWashington | $7.55 | $1.81 |
| WisconsinWisconsin | $6.14 | $1.66 |
| West VirginiaWest Virginia | $5.69 | $1.63 |
| WyomingWyoming | $6.35 | $1.67 |
17003 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $7.34 | 1 |
| AL | $5.72 | 1 |
| AR | $5.64 | 1 |
| AZ | $6.19 | 1 |
| CA | $6.85–$8.71 | 29 |
| CO | $6.68 | 1 |
| CT | $6.76 | 1 |
| DC | $7.31 | 1 |
| DE | $6.29 | 1 |
| FL | $6.13–$6.55 | 3 |
| GA | $5.81–$6.43 | 2 |
| GU | $7.03 | 1 |
| HI | $7.03 | 1 |
| IA | $5.92 | 1 |
| ID | $5.95 | 1 |
| IL | $5.91–$6.49 | 4 |
| IN | $5.98 | 1 |
| KS | $5.87 | 1 |
| KY | $5.79 | 1 |
| LA | $5.77–$6.05 | 2 |
| MA | $6.63–$7.37 | 2 |
| MD | $6.42–$7.31 | 3 |
| ME | $5.95–$6.30 | 2 |
| MI | $5.91–$6.17 | 2 |
| MN | $6.49 | 1 |
| MO | $5.65–$6.11 | 3 |
| MS | $5.65 | 1 |
| MT | $6.35 | 1 |
| NC | $6.01 | 1 |
| ND | $6.35 | 1 |
| NE | $5.96 | 1 |
| NH | $6.55 | 1 |
| NJ | $6.86–$7.23 | 2 |
| NM | $5.93 | 1 |
| NV | $6.35 | 1 |
| NY | $6.10–$7.38 | 5 |
| OH | $5.91 | 1 |
| OK | $5.81 | 1 |
| OR | $6.33–$6.92 | 2 |
| PA | $5.94–$6.58 | 2 |
| PR | $6.40 | 1 |
| RI | $6.54 | 1 |
| SC | $5.97 | 1 |
| SD | $6.35 | 1 |
| TN | $5.89 | 1 |
| TX | $5.90–$6.64 | 8 |
| UT | $6.05 | 1 |
| VA | $6.26–$7.31 | 2 |
| VI | $6.40 | 1 |
| VT | $6.30 | 1 |
| WA | $6.63–$7.55 | 2 |
| WI | $6.14 | 1 |
| WV | $5.69 | 1 |
| WY | $6.35 | 1 |
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
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 North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.04 | × 1.000 | 0.0400 |
| Practice expense | 0.15 | × 1.000 | 0.1500 |
| Malpractice | 0.00 | × 0.406 | 0.0000 |
| Total RVUs | 0.1900 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$6.35
Office: (0.04 × 1 + 0.15 × 1 + 0 × 0.406) × $33.4009 = $6.35
Facility: (0.04 × 1 + 0.01 × 1 + 0 × 0.406) × $33.4009 = $1.67
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 17003 has changed in North Dakota
17003 · Office / nonfacility
$6.35
Effective 2026-10-01
The base rate is $0.12 lower than on 2025-10-01, moving from $6.47 to $6.35 (1.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$6.47changed to$6.35
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.16 changed to 0.15
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$6.66changed to$6.47
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$6.55changed to$6.66
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$6.78changed to$6.55
- Conversion factor 33.8872 changed to 32.7442
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$6.92changed to$6.78
- Conversion factor 34.6062 changed to 33.8872
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$6.63changed to$6.92
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.15 changed to 0.16
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$6.14changed to$6.63
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.13 changed to 0.15
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$5.60changed to$6.14
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$5.23changed to$5.60
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.10 changed to 0.11
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$5.58changed to$5.23
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.11 changed to 0.10
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$5.57changed to$5.58
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$5.59changed to$5.57
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$5.56changed to$5.59
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$9.86changed to$5.56
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.23 changed to 0.11
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$6.64changed to$9.86
- Conversion factor 34.0230 changed to 35.8228
- Work RVU 0.07 changed to 0.04
- Practice expense RVU 0.12 changed to 0.23
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $6.64
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $6.35 | $1.67 | RVU26D |
| 2026-07-01 | $6.35 | $1.67 | RVU26C |
| 2026-04-01 | $6.35 | $1.67 | RVU26B |
| 2026-01-01 | $6.35 | $1.67 | RVU26A |
| 2025-10-01 | $6.47 | $1.94 | RVU25D |
| 2025-07-01 | $6.47 | $1.94 | RVU25C |
| 2025-04-01 | $6.47 | $1.94 | RVU25B |
| 2025-01-01 | $6.47 | $1.94 | RVU25A |
| 2024-10-01 | $6.66 | $2.00 | RVU24D |
| 2024-07-01 | $6.66 | $2.00 | RVU24C |
| 2024-04-01 | $6.66 | $2.00 | RVU24B |
| 2024-03-09 | $6.66 | $2.00 | RVU24AR |
| 2024-01-01 | $6.55 | $1.96 | RVU24A |
| 2023-10-01 | $6.78 | $2.03 | RVU23D |
| 2023-07-01 | $6.78 | $2.03 | RVU23C |
| 2023-04-01 | $6.78 | $2.03 | RVU23B |
| 2023-01-01 | $6.78 | $2.03 | RVU23A |
| 2022-10-01 | $6.92 | $2.08 | RVU22D |
| 2022-07-01 | $6.92 | $2.08 | RVU22C |
| 2022-04-01 | $6.92 | $2.08 | RVU22B |
| 2022-01-01 | $6.92 | $2.08 | RVU22A |
| 2021-10-01 | $6.63 | $2.09 | RVU21D |
| 2021-07-01 | $6.63 | $2.09 | RVU21C |
| 2021-04-01 | $6.63 | $2.09 | RVU21B |
| 2021-01-01 | $6.63 | $2.09 | RVU21A |
| 2020-10-01 | $6.14 | $2.17 | RVU20D |
| 2020-07-01 | $6.14 | $2.17 | RVU20C |
| 2020-04-01 | $6.14 | $2.17 | RVU20B |
| 2020-01-01 | $6.14 | $2.17 | RVU20A |
| 2019-10-01 | $5.60 | $2.36 | RVU19D |
| 2019-07-01 | $5.60 | $2.36 | RVU19C |
| 2019-04-01 | $5.60 | $2.36 | RVU19B |
| 2019-01-01 | $5.60 | $2.36 | RVU19A |
| 2018-10-01 | $5.23 | $2.35 | RVU18D |
| 2018-07-01 | $5.23 | $2.35 | RVU18C |
| 2018-04-01 | $5.23 | $2.35 | RVU18B |
| 2018-01-01 | $5.23 | $2.35 | RVU18AR1 |
| 2017-10-01 | $5.58 | $2.35 | RVU17D |
| 2017-07-01 | $5.58 | $2.35 | RVU17C |
| 2017-04-01 | $5.58 | $2.35 | RVU17B |
| 2017-01-01 | $5.58 | $2.35 | RVU17A |
| 2016-10-01 | $5.57 | $2.35 | RVU16D |
| 2016-07-01 | $5.57 | $2.35 | RVU16C |
| 2016-04-01 | $5.57 | $2.35 | RVU16B |
| 2016-01-01 | $5.57 | $2.35 | RVU16A |
| 2015-10-01 | $5.59 | $2.36 | RVU15D |
| 2015-07-01 | $5.59 | $2.36 | RVU15C |
| 2015-04-01 | $5.56 | $2.34 | RVU15B |
| 2015-01-01 | $5.56 | $2.34 | RVU15A |
| 2014-10-01 | $9.86 | $2.34 | RVU14D |
| 2014-07-01 | $9.86 | $2.34 | RVU14C |
| 2014-04-01 | $9.86 | $2.34 | RVU14B |
| 2014-01-01 | $9.86 | $2.34 | RVU14A |
| 2013-10-01 | $6.64 | $4.26 | RVU13D |
| 2013-07-01 | $6.64 | $4.26 | RVU13C |
| 2013-04-01 | $6.64 | $4.26 | RVU13B |
| 2013-01-01 | $6.64 | $4.26 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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
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