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CPT code 17004: Premalignant lesion destruction, 15 or more lesions2026 Medicare rate & RVUs in North Carolina

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.

CMS RVU26DEffective Oct 1, 2026One payment locality852.8K Medicare services in 2024

In North Carolina, Medicare pays $153.17 for 17004 in the office and $79.01 when it’s performed in a hospital or facility.

$153.17Office (non-facility)
$79.01Hospital or facility
−5.6%vs the national office rate ($162.33)

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.

We’ll open 17004 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 17004 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 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 North Carolina 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. North Carolina pays $153.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

17004 in North Carolina vs other payment areas
  1. North Carolina · this page$153.17
  2. Los Angeles, CA · California$183.43+$30.26
  3. Washington, DC area · District of Columbia$185.39+$32.22
  4. Miami, FL · Florida$173.61+$20.44
  5. Chicago, IL · Illinois$168.83+$15.66
  6. Manhattan, NY · New York$186.08+$32.91
  7. Alaska · Alaska$190.12+$36.95

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

Every other payment area

17004 in every other Medicare payment locality
Payment localityOfficeFacility
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

17004 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
17004 office rate range by state
State / territoryOffice rate rangeLocalities
AK$190.121
AL$146.291
AR$144.261
AZ$158.191
CA$171.94–$215.2829
CO$169.161
CT$172.851
DC$185.391
DE$160.751
FL$159.53–$173.613
GA$150.93–$165.152
GU$176.011
HI$176.011
IA$150.091
ID$150.981
IL$154.92–$169.054
IN$151.831
KS$149.301
KY$149.391
LA$149.12–$156.242
MA$168.16–$185.652
MD$163.78–$185.393
ME$151.63–$159.712
MI$153.04–$161.342
MN$162.561
MO$146.59–$156.903
MS$145.461
MT$162.321
NC$153.171
ND$159.751
NE$150.911
NH$166.431
NJ$174.96–$183.562
NM$153.801
NV$161.721
NY$155.38–$190.315
OH$152.511
OK$149.241
OR$160.59–$174.502
PA$152.80–$168.612
PR$163.511
RI$166.451
SC$153.071
SD$159.451
TN$150.011
TX$151.83–$168.498
UT$155.091
VA$159.13–$185.392
VI$163.511
VT$159.051
WA$167.87–$189.472
WI$154.571
WV$149.371
WY$161.201

See 17004 in every payment locality

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

Office or facility?

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 17004 in North Carolina
ComponentRVULocality factorAdjusted
Physician work1.34× 1.0001.3400
Practice expense3.39× 0.9333.1629
Malpractice0.13× 0.6390.0831
Total RVUs4.5859
Conversion factor× 33.4009

Office rate, North Carolina$153.17

Office: (1.34 × 1 + 3.39 × 0.933 + 0.13 × 0.639) × $33.4009 = $153.17

Facility: (1.34 × 1 + 1.01 × 0.933 + 0.13 × 0.639) × $33.4009 = $79.01

Open 17004 in the RVU calculator

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

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
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.
Split (54/55/56)0.10/0.80/0.10Share 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

Codes related to 17004

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 17004
CodeHow it relatesOffice range, North Carolina
Same family
17000Premalignant lesion destruction, first lesionFirst premalignant lesion; add 17003 for lesions two through fourteen.$62.75
17003Actinic keratosis destruction, lesions 2-14, each additionalAdd-on to 17000 for lesions two through fourteen; not reported with 17004.$6.01
Often billed with
17110Benign lesion destruction, up to 14 lesionsSeparately treated benign lesions, such as warts, may be reported when documented apart from premalignant lesions.$104.61
11102Tangential skin biopsy, first or only lesionTangential biopsy of a separate suspicious lesion during the same encounter.$89.97
99213Office visit, established patient, low complexitySeparately identifiable established-patient E/M when the 99213 level is supported; append modifier 25.$90.84
Used instead
96573Photodynamic therapy, includes agent applicationPhysician- or qualified-clinician-performed photodynamic therapy for premalignant lesions instead of conventional destruction.$203.73
96574Lesion debridement, for photodynamic therapyPhotodynamic therapy with debridement of hyperkeratotic premalignant lesions instead of conventional destruction.$250.79

How 17004 has changed in North Carolina

17004 · Office / nonfacility

$153.17

Effective 2026-10-01

The base rate is $1.48 higher than on 2025-10-01, moving from $151.69 to $153.17 (1.0%).

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

    $151.69changed to$153.17

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $157.43changed to$151.69

    • 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.

  3. March 9, 2024

    RVU24AR

    $154.86changed to$157.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $161.59changed to$154.86

    • 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
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $163.53changed to$161.59

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $159.99changed to$163.53

    • 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.

  7. January 1, 2021

    RVU21A

    $153.08changed to$159.99

    • 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
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $146.40changed to$153.08

    • 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 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $139.54changed to$146.40

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.55 changed to 2.75

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $144.37changed to$139.54

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.70 changed to 2.55
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $143.79changed to$144.37

    • 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 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $143.82changed to$143.79

    • 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.

  13. July 1, 2015

    RVU15C

    $143.10changed to$143.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $140.92changed to$143.10

    • 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 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $162.68changed to$140.92

    • 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 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $162.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$153.17$79.01RVU26D
2026-07-01$153.17$79.01RVU26C
2026-04-01$153.17$79.01RVU26B
2026-01-01$153.17$79.01RVU26A
2025-10-01$151.69$91.19RVU25D
2025-07-01$151.69$91.19RVU25C
2025-04-01$151.69$91.19RVU25B
2025-01-01$151.69$91.19RVU25A
2024-10-01$157.43$93.00RVU24D
2024-07-01$157.43$93.00RVU24C
2024-04-01$157.43$93.00RVU24B
2024-03-09$157.43$93.00RVU24AR
2024-01-01$154.86$91.49RVU24A
2023-10-01$161.59$94.99RVU23D
2023-07-01$161.59$94.99RVU23C
2023-04-01$161.59$94.99RVU23B
2023-01-01$161.59$94.99RVU23A
2022-10-01$163.53$94.17RVU22D
2022-07-01$163.53$94.17RVU22C
2022-04-01$163.53$94.17RVU22B
2022-01-01$163.53$94.17RVU22A
2021-10-01$159.99$94.91RVU21D
2021-07-01$159.99$94.91RVU21C
2021-04-01$159.99$94.91RVU21B
2021-01-01$159.99$94.91RVU21A
2020-10-01$153.08$96.35RVU20D
2020-07-01$153.08$96.35RVU20C
2020-04-01$153.08$96.35RVU20B
2020-01-01$153.08$96.35RVU20A
2019-10-01$146.40$97.42RVU19D
2019-07-01$146.40$97.42RVU19C
2019-04-01$146.40$97.42RVU19B
2019-01-01$146.40$97.42RVU19A
2018-10-01$139.54$97.31RVU18D
2018-07-01$139.54$97.31RVU18C
2018-04-01$139.54$97.31RVU18B
2018-01-01$139.54$97.31RVU18AR1
2017-10-01$144.37$97.60RVU17D
2017-07-01$144.37$97.60RVU17C
2017-04-01$144.37$97.60RVU17B
2017-01-01$144.37$97.60RVU17A
2016-10-01$143.79$97.51RVU16D
2016-07-01$143.79$97.51RVU16C
2016-04-01$143.79$97.51RVU16B
2016-01-01$143.79$97.51RVU16A
2015-10-01$143.82$97.03RVU15D
2015-07-01$143.82$97.03RVU15C
2015-04-01$143.10$96.55RVU15B
2015-01-01$143.10$96.55RVU15A
2014-10-01$140.92$95.99RVU14D
2014-07-01$140.92$95.99RVU14C
2014-04-01$140.92$95.99RVU14B
2014-01-01$140.92$95.99RVU14A
2013-10-01$162.68$124.84RVU13D
2013-07-01$162.68$124.84RVU13C
2013-04-01$162.68$124.84RVU13B
2013-01-01$162.68$124.84RVU13AR

Price 17004 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 17004PPRRVU2026_Oct_nonQPP.csv, line 1,621 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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