CPT code 17004: Premalignant lesion destruction, 15 or more lesions2026 Medicare rate & RVUs in Colorado
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.
In Colorado, Medicare pays $169.16 for 17004 in the office and $84.58 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 17004 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 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.
How Colorado compares for 17004
Across 109 of 109 payment localities, the office rate for 17004 runs from $144.26 in Arkansas to $215.28 in San Benito County, CA. Colorado pays $169.16. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$169.16
- Los Angeles, CA · California$183.43+$14.27
- Washington, DC area · District of Columbia$185.39+$16.23
- Miami, FL · Florida$173.61+$4.45
- Chicago, IL · Illinois$168.83−$0.33
- Manhattan, NY · New York$186.08+$16.92
- Alaska · Alaska$190.12+$20.96
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $146.29 | $76.73 |
| ArkansasArkansas | $144.26 | $75.97 |
| ArizonaArizona | $158.19 | $81.16 |
| Bakersfield, CACalifornia | $172.35 | $85.23 |
| Chico, CACalifornia | $171.94 | $84.82 |
| El Centro, CACalifornia | $171.97 | $84.84 |
| Fresno, CACalifornia | $171.94 | $84.82 |
| Hanford, CACalifornia | $171.94 | $84.82 |
| Madera, CACalifornia | $171.94 | $84.82 |
| Merced, CACalifornia | $171.94 | $84.82 |
| Modesto, CACalifornia | $171.94 | $84.82 |
| Napa, CACalifornia | $199.02 | $94.25 |
| Oxnard, CACalifornia | $182.55 | $88.59 |
| Redding, CACalifornia | $171.94 | $84.82 |
| Rest of CaliforniaCalifornia | $171.94 | $84.82 |
| Riverside, CACalifornia | $173.37 | $86.24 |
| Sacramento, CACalifornia | $180.38 | $87.93 |
| Salinas, CACalifornia | $179.70 | $87.57 |
| San Diego, CACalifornia | $183.88 | $88.80 |
| Marin County, CACalifornia | $210.66 | $98.57 |
| San Francisco, CACalifornia | $210.51 | $98.42 |
| San Benito County, CACalifornia | $215.28 | $100.65 |
| Santa Clara County, CACalifornia | $214.68 | $100.05 |
| San Luis Obispo, CACalifornia | $176.81 | $86.27 |
| Santa Cruz, CACalifornia | $185.60 | $89.01 |
| Santa Maria, CACalifornia | $180.36 | $87.67 |
| Santa Rosa, CACalifornia | $187.47 | $89.85 |
| Stockton, CACalifornia | $171.94 | $84.82 |
| Vallejo, CACalifornia | $198.81 | $94.03 |
| Visalia, CACalifornia | $171.94 | $84.82 |
| Yuba City, CACalifornia | $171.94 | $84.82 |
| ConnecticutConnecticut | $172.85 | $87.24 |
| DelawareDelaware | $160.75 | $82.21 |
| Fort Lauderdale, FLFlorida | $167.31 | $86.78 |
| Rest of FloridaFlorida | $159.53 | $83.53 |
| Atlanta, GAGeorgia | $165.15 | $84.38 |
| Rest of GeorgiaGeorgia | $150.93 | $80.02 |
| Hawaii, Guam, HIHawaii | $176.01 | $85.63 |
| IowaIowa | $150.09 | $77.35 |
| IdahoIdaho | $150.98 | $77.85 |
| East St. Louis, ILIllinois | $157.67 | $84.54 |
| Rest of IllinoisIllinois | $154.92 | $82.34 |
| Suburban Chicago, ILIllinois | $169.05 | $87.41 |
| IndianaIndiana | $151.83 | $78.14 |
| KansasKansas | $149.30 | $77.44 |
| KentuckyKentucky | $149.39 | $78.72 |
| New Orleans, LALouisiana | $156.24 | $81.43 |
| Rest of LouisianaLouisiana | $149.12 | $78.77 |
| Metropolitan Boston, MAMassachusetts | $185.65 | $90.74 |
| Rest of MassachusettsMassachusetts | $168.16 | $84.46 |
| Baltimore area, MDMaryland | $172.34 | $87.04 |
| Rest of MarylandMaryland | $163.78 | $83.33 |
| Rest of MaineMaine | $151.63 | $78.49 |
| Southern Maine, MEMaine | $159.71 | $80.93 |
| Detroit, MIMichigan | $161.34 | $84.63 |
| Rest of MichiganMichigan | $153.04 | $80.46 |
| MinnesotaMinnesota | $162.56 | $80.76 |
| Metropolitan Kansas City, MOMissouri | $155.32 | $80.68 |
| Metropolitan St. Louis, MOMissouri | $156.90 | $81.22 |
| Rest of MissouriMissouri | $146.59 | $78.07 |
| MississippiMississippi | $145.46 | $77.01 |
| MontanaMontana | $162.32 | $82.83 |
| North CarolinaNorth Carolina | $153.17 | $79.01 |
| North DakotaNorth Dakota | $159.75 | $80.26 |
| NebraskaNebraska | $150.91 | $77.54 |
| New HampshireNew Hampshire | $166.43 | $83.67 |
| Northern New JerseyNew Jersey | $183.56 | $91.35 |
| Rest of New JerseyNew Jersey | $174.96 | $88.15 |
| New MexicoNew Mexico | $153.80 | $80.91 |
| NevadaNevada | $161.72 | $82.14 |
| NYC suburbs and Long Island, NYNew York | $190.31 | $95.80 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $176.01 | $88.96 |
| Queens, NYNew York | $187.72 | $93.76 |
| Rest of New YorkNew York | $155.38 | $79.86 |
| OhioOhio | $152.51 | $79.93 |
| OklahomaOklahoma | $149.24 | $78.26 |
| Portland, OROregon | $174.50 | $86.18 |
| Rest of OregonOregon | $160.59 | $81.41 |
| Metropolitan Philadelphia, PAPennsylvania | $168.61 | $85.86 |
| Rest of PennsylvaniaPennsylvania | $152.80 | $79.83 |
| Puerto RicoPuerto Rico | $163.51 | $83.14 |
| Rhode IslandRhode Island | $166.45 | $84.33 |
| South CarolinaSouth Carolina | $153.07 | $79.62 |
| South DakotaSouth Dakota | $159.45 | $79.95 |
| TennesseeTennessee | $150.01 | $77.75 |
| Austin, TXTexas | $168.49 | $84.39 |
| Beaumont, TXTexas | $151.83 | $79.49 |
| Brazoria, TXTexas | $160.71 | $81.93 |
| Dallas, TXTexas | $161.66 | $82.49 |
| Fort Worth, TXTexas | $160.59 | $82.20 |
| Galveston, TXTexas | $161.15 | $82.21 |
| Houston, TXTexas | $163.53 | $84.59 |
| Rest of TexasTexas | $156.13 | $80.69 |
| UtahUtah | $155.09 | $80.37 |
| VirginiaVirginia | $159.13 | $80.98 |
| Virgin Islands, VIUnited States Virgin Islands | $163.51 | $83.14 |
| VermontVermont | $159.05 | $80.35 |
| Rest of WashingtonWashington | $167.87 | $84.17 |
| King County, WAWashington | $189.47 | $91.94 |
| WisconsinWisconsin | $154.57 | $78.41 |
| West VirginiaWest Virginia | $149.37 | $80.29 |
| WyomingWyoming | $161.20 | $81.71 |
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.
The exact Colorado inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,621
- Code
- 17004
- Physician work
- 1.34
- Practice expense
- 3.39
- Malpractice
- 0.13
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.34 | × 1.012 | 1.3561 |
| Practice expense | 3.39 | × 1.064 | 3.6070 |
| Malpractice | 0.13 | × 0.781 | 0.1015 |
| Total RVUs | 5.0646 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Colorado$169.16
Office: (1.34 × 1.012 + 3.39 × 1.064 + 0.13 × 0.781) × $33.4009 = $169.16
Facility: (1.34 × 1.012 + 1.01 × 1.064 + 0.13 × 0.781) × $33.4009 = $84.58
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.
How 17004 has changed in Colorado
17004 · Office / nonfacility
$169.16
Effective 2026-10-01
The base rate is $2.02 higher than on 2025-10-01, moving from $167.14 to $169.16 (1.2%).
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
$167.14changed to$169.16
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.37 changed to 1.34
- Practice expense RVU 3.47 changed to 3.39
- Malpractice RVU 0.16 changed to 0.13
- Work GPCI 1.008 changed to 1.012
- Practice expense GPCI 1.053 changed to 1.064
- Malpractice GPCI 0.827 changed to 0.781
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$173.48changed to$167.14
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.52 changed to 3.47
- Malpractice RVU 0.15 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$170.65changed to$173.48
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$176.85changed to$170.65
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.53 changed to 3.52
- Malpractice RVU 0.17 changed to 0.15
- Work GPCI 1.005 changed to 1.008
- Practice expense GPCI 1.050 changed to 1.053
- Malpractice GPCI 0.797 changed to 0.827
January 1, 2023
RVU23A
$177.82changed to$176.85
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.51 changed to 3.53
- Malpractice RVU 0.12 changed to 0.17
- Work GPCI 1.001 changed to 1.005
- Practice expense GPCI 1.047 changed to 1.050
- Malpractice GPCI 0.767 changed to 0.797
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$173.72changed to$177.82
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.35 changed to 3.51
- Malpractice RVU 0.13 changed to 0.12
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$164.83changed to$173.72
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.99 changed to 3.35
- Malpractice RVU 0.12 changed to 0.13
- Work GPCI 1.000 changed to 1.001
- Practice expense GPCI 1.033 changed to 1.047
- Malpractice GPCI 0.905 changed to 0.767
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$157.40changed to$164.83
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.75 changed to 2.99
- Malpractice RVU 0.19 changed to 0.12
- Practice expense GPCI 1.018 changed to 1.033
- Malpractice GPCI 1.042 changed to 0.905
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$149.90changed to$157.40
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.55 changed to 2.75
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$154.79changed to$149.90
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.70 changed to 2.55
- Practice expense GPCI 1.015 changed to 1.018
- Malpractice GPCI 1.066 changed to 1.042
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$153.87changed to$154.79
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.68 changed to 2.70
- Malpractice RVU 0.20 changed to 0.19
- Practice expense GPCI 1.011 changed to 1.015
- Malpractice GPCI 1.090 changed to 1.066
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$153.61changed to$153.87
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.69 changed to 2.68
- Malpractice RVU 0.17 changed to 0.20
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$152.85changed to$153.61
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$150.00changed to$152.85
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.61 changed to 2.69
- Malpractice RVU 0.19 changed to 0.17
- Practice expense GPCI 1.008 changed to 1.011
- Malpractice GPCI 0.981 changed to 1.090
Held through RVU15B.
January 1, 2014
RVU14A
$172.06changed to$150.00
- Conversion factor 34.0230 changed to 35.8228
- Work RVU 1.85 changed to 1.37
- Practice expense RVU 2.96 changed to 2.61
- Malpractice RVU 0.27 changed to 0.19
- Practice expense GPCI 1.004 changed to 1.008
- Malpractice GPCI 0.872 changed to 0.981
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $172.06
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $169.16 | $84.58 | RVU26D |
| 2026-07-01 | $169.16 | $84.58 | RVU26C |
| 2026-04-01 | $169.16 | $84.58 | RVU26B |
| 2026-01-01 | $169.16 | $84.58 | RVU26A |
| 2025-10-01 | $167.14 | $98.34 | RVU25D |
| 2025-07-01 | $167.14 | $98.34 | RVU25C |
| 2025-04-01 | $167.14 | $98.34 | RVU25B |
| 2025-01-01 | $167.14 | $98.34 | RVU25A |
| 2024-10-01 | $173.48 | $100.22 | RVU24D |
| 2024-07-01 | $173.48 | $100.22 | RVU24C |
| 2024-04-01 | $173.48 | $100.22 | RVU24B |
| 2024-03-09 | $173.48 | $100.22 | RVU24AR |
| 2024-01-01 | $170.65 | $98.59 | RVU24A |
| 2023-10-01 | $176.85 | $101.42 | RVU23D |
| 2023-07-01 | $176.85 | $101.42 | RVU23C |
| 2023-04-01 | $176.85 | $101.42 | RVU23B |
| 2023-01-01 | $176.85 | $101.42 | RVU23A |
| 2022-10-01 | $177.82 | $99.56 | RVU22D |
| 2022-07-01 | $177.82 | $99.56 | RVU22C |
| 2022-04-01 | $177.82 | $99.56 | RVU22B |
| 2022-01-01 | $177.82 | $99.56 | RVU22A |
| 2021-10-01 | $173.72 | $100.28 | RVU21D |
| 2021-07-01 | $173.72 | $100.28 | RVU21C |
| 2021-04-01 | $173.72 | $100.28 | RVU21B |
| 2021-01-01 | $173.72 | $100.28 | RVU21A |
| 2020-10-01 | $164.83 | $101.83 | RVU20D |
| 2020-07-01 | $164.83 | $101.83 | RVU20C |
| 2020-04-01 | $164.83 | $101.83 | RVU20B |
| 2020-01-01 | $164.83 | $101.83 | RVU20A |
| 2019-10-01 | $157.40 | $103.84 | RVU19D |
| 2019-07-01 | $157.40 | $103.84 | RVU19C |
| 2019-04-01 | $157.40 | $103.84 | RVU19B |
| 2019-01-01 | $157.40 | $103.84 | RVU19A |
| 2018-10-01 | $149.90 | $103.72 | RVU18D |
| 2018-07-01 | $149.90 | $103.72 | RVU18C |
| 2018-04-01 | $149.90 | $103.72 | RVU18B |
| 2018-01-01 | $149.90 | $103.72 | RVU18AR1 |
| 2017-10-01 | $154.79 | $103.79 | RVU17D |
| 2017-07-01 | $154.79 | $103.79 | RVU17C |
| 2017-04-01 | $154.79 | $103.79 | RVU17B |
| 2017-01-01 | $154.79 | $103.79 | RVU17A |
| 2016-10-01 | $153.87 | $103.55 | RVU16D |
| 2016-07-01 | $153.87 | $103.55 | RVU16C |
| 2016-04-01 | $153.87 | $103.55 | RVU16B |
| 2016-01-01 | $153.87 | $103.55 | RVU16A |
| 2015-10-01 | $153.61 | $102.75 | RVU15D |
| 2015-07-01 | $153.61 | $102.75 | RVU15C |
| 2015-04-01 | $152.85 | $102.24 | RVU15B |
| 2015-01-01 | $152.85 | $102.24 | RVU15A |
| 2014-10-01 | $150.00 | $101.25 | RVU14D |
| 2014-07-01 | $150.00 | $101.25 | RVU14C |
| 2014-04-01 | $150.00 | $101.25 | RVU14B |
| 2014-01-01 | $150.00 | $101.25 | RVU14A |
| 2013-10-01 | $172.06 | $131.07 | RVU13D |
| 2013-07-01 | $172.06 | $131.07 | RVU13C |
| 2013-04-01 | $172.06 | $131.07 | RVU13B |
| 2013-01-01 | $172.06 | $131.07 | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
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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