CPT code 17004: Premalignant lesion destruction, 15 or more lesions2026 Medicare rate & RVUs in New Mexico
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 New Mexico, Medicare pays $153.80 for 17004 in the office and $80.91 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 New Mexico 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. New Mexico pays $153.80. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$153.80
- Los Angeles, CA · California$183.43+$29.63
- Washington, DC area · District of Columbia$185.39+$31.59
- Miami, FL · Florida$173.61+$19.81
- Chicago, IL · Illinois$168.83+$15.03
- Manhattan, NY · New York$186.08+$32.28
- Alaska · Alaska$190.12+$36.32
Other areas in New Mexico 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 |
| ColoradoColorado | $169.16 | $84.58 |
| 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 |
| 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 New Mexico 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
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.34 | × 1.000 | 1.3400 |
| Practice expense | 3.39 | × 0.917 | 3.1086 |
| Malpractice | 0.13 | × 1.201 | 0.1561 |
| Total RVUs | 4.6048 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$153.80
Office: (1.34 × 1 + 3.39 × 0.917 + 0.13 × 1.201) × $33.4009 = $153.80
Facility: (1.34 × 1 + 1.01 × 0.917 + 0.13 × 1.201) × $33.4009 = $80.91
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 New Mexico
17004 · Office / nonfacility
$153.80
Effective 2026-10-01
The base rate is $1.50 higher than on 2025-10-01, moving from $152.30 to $153.80 (1.0%).
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
$152.30changed to$153.80
- 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 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$157.85changed to$152.30
- 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
$155.27changed to$157.85
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$161.06changed to$155.27
- 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 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$161.09changed to$161.06
- 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 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$157.83changed to$161.09
- 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
$152.65changed to$157.83
- 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 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$149.19changed to$152.65
- 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 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$142.40changed to$149.19
- 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
$146.52changed to$142.40
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.70 changed to 2.55
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$145.55changed to$146.52
- 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 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$145.15changed to$145.55
- 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
$144.43changed to$145.15
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$142.25changed to$144.43
- 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 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$164.35changed to$142.25
- 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 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $164.35
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $153.80 | $80.91 | RVU26D |
| 2026-07-01 | $153.80 | $80.91 | RVU26C |
| 2026-04-01 | $153.80 | $80.91 | RVU26B |
| 2026-01-01 | $153.80 | $80.91 | RVU26A |
| 2025-10-01 | $152.30 | $92.97 | RVU25D |
| 2025-07-01 | $152.30 | $92.97 | RVU25C |
| 2025-04-01 | $152.30 | $92.97 | RVU25B |
| 2025-01-01 | $152.30 | $92.97 | RVU25A |
| 2024-10-01 | $157.85 | $94.68 | RVU24D |
| 2024-07-01 | $157.85 | $94.68 | RVU24C |
| 2024-04-01 | $157.85 | $94.68 | RVU24B |
| 2024-03-09 | $157.85 | $94.68 | RVU24AR |
| 2024-01-01 | $155.27 | $93.13 | RVU24A |
| 2023-10-01 | $161.06 | $96.26 | RVU23D |
| 2023-07-01 | $161.06 | $96.26 | RVU23C |
| 2023-04-01 | $161.06 | $96.26 | RVU23B |
| 2023-01-01 | $161.06 | $96.26 | RVU23A |
| 2022-10-01 | $161.09 | $94.11 | RVU22D |
| 2022-07-01 | $161.09 | $94.11 | RVU22C |
| 2022-04-01 | $161.09 | $94.11 | RVU22B |
| 2022-01-01 | $161.09 | $94.11 | RVU22A |
| 2021-10-01 | $157.83 | $94.99 | RVU21D |
| 2021-07-01 | $157.83 | $94.99 | RVU21C |
| 2021-04-01 | $157.83 | $94.99 | RVU21B |
| 2021-01-01 | $157.83 | $94.99 | RVU21A |
| 2020-10-01 | $152.65 | $97.27 | RVU20D |
| 2020-07-01 | $152.65 | $97.27 | RVU20C |
| 2020-04-01 | $152.65 | $97.27 | RVU20B |
| 2020-01-01 | $152.65 | $97.27 | RVU20A |
| 2019-10-01 | $149.19 | $100.73 | RVU19D |
| 2019-07-01 | $149.19 | $100.73 | RVU19C |
| 2019-04-01 | $149.19 | $100.73 | RVU19B |
| 2019-01-01 | $149.19 | $100.73 | RVU19A |
| 2018-10-01 | $142.40 | $100.62 | RVU18D |
| 2018-07-01 | $142.40 | $100.62 | RVU18C |
| 2018-04-01 | $142.40 | $100.62 | RVU18B |
| 2018-01-01 | $142.40 | $100.62 | RVU18AR1 |
| 2017-10-01 | $146.52 | $100.30 | RVU17D |
| 2017-07-01 | $146.52 | $100.30 | RVU17C |
| 2017-04-01 | $146.52 | $100.30 | RVU17B |
| 2017-01-01 | $146.52 | $100.30 | RVU17A |
| 2016-10-01 | $145.55 | $99.81 | RVU16D |
| 2016-07-01 | $145.55 | $99.81 | RVU16C |
| 2016-04-01 | $145.55 | $99.81 | RVU16B |
| 2016-01-01 | $145.55 | $99.81 | RVU16A |
| 2015-10-01 | $145.15 | $98.92 | RVU15D |
| 2015-07-01 | $145.15 | $98.92 | RVU15C |
| 2015-04-01 | $144.43 | $98.43 | RVU15B |
| 2015-01-01 | $144.43 | $98.43 | RVU15A |
| 2014-10-01 | $142.25 | $97.86 | RVU14D |
| 2014-07-01 | $142.25 | $97.86 | RVU14C |
| 2014-04-01 | $142.25 | $97.86 | RVU14B |
| 2014-01-01 | $142.25 | $97.86 | RVU14A |
| 2013-10-01 | $164.35 | $126.95 | RVU13D |
| 2013-07-01 | $164.35 | $126.95 | RVU13C |
| 2013-04-01 | $164.35 | $126.95 | RVU13B |
| 2013-01-01 | $164.35 | $126.95 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
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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