CPT code 17004: Premalignant lesion destruction, 15 or more lesions2026 Medicare rate & RVUs
Destruction of 15 or more premalignant skin lesions, most often actinic keratoses, at one session, reported as a single unit instead of 17000 and 17003.
Medicare pays $162.33 for 17004 nationally in the office and $82.83 in a hospital or facility. Local office rates run $144.26–$215.28.
Medicare rate · 17004
Premalignant lesion destruction, 15 or more lesions
- Work RVUs
- 1.34
- Total RVUs
- 4.86
- Global days
- 010
National rate · 2026
$162.33
Office setting, before claim adjustments.
See every locality for 17004 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 17004 covers
This service covers destroying 15 or more premalignant skin lesions in one session. A typical case involves numerous actinic keratoses on the face, scalp, ears, forearms, or hands. Dermatologists, primary care physicians, and advanced practice clinicians perform it, most often in the office. Liquid nitrogen cryosurgery is the usual method. Curettement, electrosurgery, chemical destruction, and laser are also methods of destruction. Count the premalignant lesions treated during the session, regardless of their locations.
When 15 or more lesions are treated, report one unit of 17004, not 17000 or 17003. For fewer lesions, report 17000 for the first and one unit of 17003 for each additional lesion through the fourteenth. Documentation should state the count, anatomic locations, diagnosis, and destruction method. The procedure has a 10-day global period, which includes related postoperative visits during those 10 days. Modifier 50 is inappropriate even when lesions are treated on both sides of the body. CMS does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
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.
Where 17004 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$144.26 to $215.28
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $146.29 | $76.73 |
| Alaska | $190.12 | $105.46 |
| Arizona | $158.19 | $81.16 |
| Arkansas | $144.26 | $75.97 |
| Atlanta, GA | $165.15 | $84.38 |
| Austin, TX | $168.49 | $84.39 |
| Bakersfield, CA | $172.35 | $85.23 |
| Baltimore area, MD | $172.34 | $87.04 |
| Beaumont, TX | $151.83 | $79.49 |
| Brazoria, TX | $160.71 | $81.93 |
| Chicago, IL | $168.83 | $88.94 |
| Chico, CA | $171.94 | $84.82 |
| Colorado | $169.16 | $84.58 |
| Connecticut | $172.85 | $87.24 |
| Dallas, TX | $161.66 | $82.49 |
| Delaware | $160.75 | $82.21 |
| Detroit, MI | $161.34 | $84.63 |
| East St. Louis, IL | $157.67 | $84.54 |
| El Centro, CA | $171.97 | $84.84 |
| Fort Lauderdale, FL | $167.31 | $86.78 |
| Fort Worth, TX | $160.59 | $82.20 |
| Fresno, CA | $171.94 | $84.82 |
| Galveston, TX | $161.15 | $82.21 |
| Hanford, CA | $171.94 | $84.82 |
| Hawaii, Guam, HI | $176.01 | $85.63 |
| Houston, TX | $163.53 | $84.59 |
| Idaho | $150.98 | $77.85 |
| Indiana | $151.83 | $78.14 |
| Iowa | $150.09 | $77.35 |
| Kansas | $149.30 | $77.44 |
| Kentucky | $149.39 | $78.72 |
| King County, WA | $189.47 | $91.94 |
| Los Angeles, CA | $183.43 | $89.38 |
| Madera, CA | $171.94 | $84.82 |
| Manhattan, NY | $186.08 | $93.71 |
| Marin County, CA | $210.66 | $98.57 |
| Merced, CA | $171.94 | $84.82 |
| Metropolitan Boston, MA | $185.65 | $90.74 |
| Metropolitan Kansas City, MO | $155.32 | $80.68 |
| Metropolitan Philadelphia, PA | $168.61 | $85.86 |
| Metropolitan St. Louis, MO | $156.90 | $81.22 |
| Miami, FL | $173.61 | $90.86 |
| Minnesota | $162.56 | $80.76 |
| Mississippi | $145.46 | $77.01 |
| Modesto, CA | $171.94 | $84.82 |
| Montana | $162.32 | $82.83 |
| Napa, CA | $199.02 | $94.25 |
| Nebraska | $150.91 | $77.54 |
| Nevada | $161.72 | $82.14 |
| New Hampshire | $166.43 | $83.67 |
| New Mexico | $153.80 | $80.91 |
| New Orleans, LA | $156.24 | $81.43 |
| North Carolina | $153.17 | $79.01 |
| North Dakota | $159.75 | $80.26 |
| Northern New Jersey | $183.56 | $91.35 |
| NYC suburbs and Long Island, NY | $190.31 | $95.80 |
| Ohio | $152.51 | $79.93 |
| Oklahoma | $149.24 | $78.26 |
| Oxnard, CA | $182.55 | $88.59 |
| Portland, OR | $174.50 | $86.18 |
| Poughkeepsie and northern NYC suburbs, NY | $176.01 | $88.96 |
| Puerto Rico | $163.51 | $83.14 |
| Queens, NY | $187.72 | $93.76 |
| Redding, CA | $171.94 | $84.82 |
| Rest of California | $171.94 | $84.82 |
| Rest of Florida | $159.53 | $83.53 |
| Rest of Georgia | $150.93 | $80.02 |
| Rest of Illinois | $154.92 | $82.34 |
| Rest of Louisiana | $149.12 | $78.77 |
| Rest of Maine | $151.63 | $78.49 |
| Rest of Maryland | $163.78 | $83.33 |
| Rest of Massachusetts | $168.16 | $84.46 |
| Rest of Michigan | $153.04 | $80.46 |
| Rest of Missouri | $146.59 | $78.07 |
| Rest of New Jersey | $174.96 | $88.15 |
| Rest of New York | $155.38 | $79.86 |
| Rest of Oregon | $160.59 | $81.41 |
| Rest of Pennsylvania | $152.80 | $79.83 |
| Rest of Texas | $156.13 | $80.69 |
| Rest of Washington | $167.87 | $84.17 |
| Rhode Island | $166.45 | $84.33 |
| Riverside, CA | $173.37 | $86.24 |
| Sacramento, CA | $180.38 | $87.93 |
| Salinas, CA | $179.70 | $87.57 |
| San Benito County, CA | $215.28 | $100.65 |
| San Diego, CA | $183.88 | $88.80 |
| San Francisco, CA | $210.51 | $98.42 |
| San Luis Obispo, CA | $176.81 | $86.27 |
| Santa Clara County, CA | $214.68 | $100.05 |
| Santa Cruz, CA | $185.60 | $89.01 |
| Santa Maria, CA | $180.36 | $87.67 |
| Santa Rosa, CA | $187.47 | $89.85 |
| South Carolina | $153.07 | $79.62 |
| South Dakota | $159.45 | $79.95 |
| Southern Maine, ME | $159.71 | $80.93 |
| Stockton, CA | $171.94 | $84.82 |
| Suburban Chicago, IL | $169.05 | $87.41 |
| Tennessee | $150.01 | $77.75 |
| Utah | $155.09 | $80.37 |
| Vallejo, CA | $198.81 | $94.03 |
| Vermont | $159.05 | $80.35 |
| Virgin Islands, VI | $163.51 | $83.14 |
| Virginia | $159.13 | $80.98 |
| Visalia, CA | $171.94 | $84.82 |
| Washington, DC area | $185.39 | $91.75 |
| West Virginia | $149.37 | $80.29 |
| Wisconsin | $154.57 | $78.41 |
| Wyoming | $161.20 | $81.71 |
| Yuba City, CA | $171.94 | $84.82 |
17004 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.
$144.26
$193.61
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 | $190.12 | 1 |
| AL | $146.29 | 1 |
| AR | $144.26 | 1 |
| AZ | $158.19 | 1 |
| CA | $171.94–$215.28 | 29 |
| CO | $169.16 | 1 |
| CT | $172.85 | 1 |
| DC | $185.39 | 1 |
| DE | $160.75 | 1 |
| FL | $159.53–$173.61 | 3 |
| GA | $150.93–$165.15 | 2 |
| GU | $176.01 | 1 |
| HI | $176.01 | 1 |
| IA | $150.09 | 1 |
| ID | $150.98 | 1 |
| IL | $154.92–$169.05 | 4 |
| IN | $151.83 | 1 |
| KS | $149.30 | 1 |
| KY | $149.39 | 1 |
| LA | $149.12–$156.24 | 2 |
| MA | $168.16–$185.65 | 2 |
| MD | $163.78–$185.39 | 3 |
| ME | $151.63–$159.71 | 2 |
| MI | $153.04–$161.34 | 2 |
| MN | $162.56 | 1 |
| MO | $146.59–$156.90 | 3 |
| MS | $145.46 | 1 |
| MT | $162.32 | 1 |
| NC | $153.17 | 1 |
| ND | $159.75 | 1 |
| NE | $150.91 | 1 |
| NH | $166.43 | 1 |
| NJ | $174.96–$183.56 | 2 |
| NM | $153.80 | 1 |
| NV | $161.72 | 1 |
| NY | $155.38–$190.31 | 5 |
| OH | $152.51 | 1 |
| OK | $149.24 | 1 |
| OR | $160.59–$174.50 | 2 |
| PA | $152.80–$168.61 | 2 |
| PR | $163.51 | 1 |
| RI | $166.45 | 1 |
| SC | $153.07 | 1 |
| SD | $159.45 | 1 |
| TN | $150.01 | 1 |
| TX | $151.83–$168.49 | 8 |
| UT | $155.09 | 1 |
| VA | $159.13–$185.39 | 2 |
| VI | $163.51 | 1 |
| VT | $159.05 | 1 |
| WA | $167.87–$189.47 | 2 |
| WI | $154.57 | 1 |
| WV | $149.37 | 1 |
| WY | $161.20 | 1 |
How the 17004 rate is calculated
Each of 17004’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 · 17004
RVUs × geographic indexes × conversion factor
Work1.34
1.34 RVUs× 1.000 GPCI
Practice expense3.39
3.39 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
4.8600
Conversion factor
$33.4009
Medicare rate
$162.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 17004
17004 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 17004
Premalignant lesion destruction, 15 or more lesions
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 17004
Premalignant lesion destruction, 15 or more lesions
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
17004 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 17000Premalignant lesion destructionFirst lesion
- Use 17000, adding 17003 for lesions two through fourteen, when fewer than 15 premalignant lesions are destroyed. Use 17004 alone when the count reaches 15.
- 17003Actinic keratosis destructionLesions 2-14, each additional
- 17003 is reported per additional lesion for lesions two through fourteen, with 17000. At 15 or more lesions, report one unit of 17004 instead.
- 17110Benign lesion destructionUp to 14 lesions
- 17110 covers benign lesions such as common warts and molluscum. Actinic keratoses and other premalignant lesions belong in the 17000–17004 series.
- 17260Skin lesion destructionTrunk, arms, legs, 0.5 cm or less
- The 17260 series covers destruction of malignant lesions and is selected by lesion diameter and anatomic site. Code 17004 covers premalignant lesions and is selected by count, not size.
17004 billing questions
How many units of 17004 are reported if 30 actinic keratoses are destroyed?
One unit. This code covers 15 or more lesions in a single session regardless of how many above that threshold are treated.
Can 17000 and 17003 be reported along with 17004?
No. At 15 or more premalignant lesions in a session, 17004 replaces the 17000 and 17003 combination. Reporting them together would duplicate the lesion destruction.
Can an E/M visit be billed on the same day?
Yes, if the E/M service is significant and separately identifiable from the usual assessment for this minor procedure, such as evaluation of an unrelated problem. Append modifier 25 to the E/M code; the routine decision to destroy the lesions is included in the procedure.
Is a biopsy of a different lesion separately reportable?
Yes, when a separate suspicious lesion is biopsied rather than destroyed. Report the appropriate biopsy code, such as 11102 for a tangential biopsy; use modifier 59 or XS when an edit requires a distinct-service modifier, and document both lesions.
Should the treated lesions be listed by location?
Yes. Record the total count and anatomic sites, such as the face, scalp, and dorsal hands, so the 15-lesion threshold can be verified.
What if photodynamic therapy is used instead of conventional destruction?
For physician- or qualified-health-care-professional-performed photodynamic therapy with application and activation of a photosensitizing drug, report 96573 instead. Report 96574 when that service also includes debridement of hyperkeratotic premalignant lesions.
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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