CPT code 17264: Skin lesion destruction, trunk, arms, or legs; 3.1–4.0 cm2026 Medicare rate & RVUs in Connecticut
Destruction of a malignant skin lesion measuring 3.1–4.0 cm on the trunk, an arm, or a leg, selected by site and lesion diameter.
In Connecticut, Medicare pays $214.79 for 17264 in the office and $114.78 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 17264 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 17264 covers
This service treats a malignant skin lesion on the trunk, an arm, or a leg by destroying the lesion rather than removing it as an intact excision specimen. A dermatologist or other physician may perform the treatment in an office or facility using a destructive technique appropriate to the lesion. The measurement and location determine the code family level; this code is for a lesion measuring 3.1–4.0 cm in the specified anatomic group.
Report the documented malignant diagnosis, exact site, pretreatment lesion diameter, and treatment performed. Use the neighboring size level when the measurement falls outside this range, and use a different site group for lesions on the scalp, neck, hands, feet, genitalia, face, ears, eyelids, nose, lips, or mucous membranes. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; 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 Connecticut compares for 17264
Across 109 of 109 payment localities, the office rate for 17264 runs from $180.54 in Arkansas to $264.13 in San Benito County, CA. Connecticut pays $214.79. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Connecticut · this page$214.79
- Los Angeles, CA · California$226.56+$11.77
- Washington, DC area · District of Columbia$229.60+$14.81
- Miami, FL · Florida$217.15+$2.36
- Chicago, IL · Illinois$211.40−$3.39
- Manhattan, NY · New York$231.15+$16.36
- Alaska · Alaska$240.14+$25.35
Other areas in Connecticut first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $182.95 | $101.71 |
| ArkansasArkansas | $180.54 | $100.77 |
| ArizonaArizona | $197.10 | $107.13 |
| Bakersfield, CACalifornia | $213.39 | $111.63 |
| Chico, CACalifornia | $212.80 | $111.03 |
| El Centro, CACalifornia | $212.83 | $111.07 |
| Fresno, CACalifornia | $212.80 | $111.03 |
| Hanford, CACalifornia | $212.80 | $111.03 |
| Madera, CACalifornia | $212.80 | $111.03 |
| Merced, CACalifornia | $212.80 | $111.03 |
| Modesto, CACalifornia | $212.80 | $111.03 |
| Napa, CACalifornia | $244.67 | $122.29 |
| Oxnard, CACalifornia | $225.33 | $115.57 |
| Redding, CACalifornia | $212.80 | $111.03 |
| Rest of CaliforniaCalifornia | $212.80 | $111.03 |
| Riverside, CACalifornia | $214.88 | $113.11 |
| Sacramento, CACalifornia | $222.81 | $114.82 |
| Salinas, CACalifornia | $221.96 | $114.34 |
| San Diego, CACalifornia | $226.78 | $115.72 |
| Marin County, CACalifornia | $258.48 | $127.56 |
| San Francisco, CACalifornia | $258.26 | $127.34 |
| San Benito County, CACalifornia | $264.13 | $130.23 |
| Santa Clara County, CACalifornia | $263.25 | $129.35 |
| San Luis Obispo, CACalifornia | $218.43 | $112.67 |
| Santa Cruz, CACalifornia | $228.64 | $115.82 |
| Santa Maria, CACalifornia | $222.68 | $114.41 |
| Santa Rosa, CACalifornia | $230.93 | $116.90 |
| Stockton, CACalifornia | $212.80 | $111.03 |
| Vallejo, CACalifornia | $244.36 | $121.98 |
| Visalia, CACalifornia | $212.80 | $111.03 |
| Yuba City, CACalifornia | $212.80 | $111.03 |
| ColoradoColorado | $209.84 | $111.05 |
| DelawareDelaware | $200.19 | $108.45 |
| Fort Lauderdale, FLFlorida | $208.91 | $114.84 |
| Rest of FloridaFlorida | $199.51 | $110.74 |
| Atlanta, GAGeorgia | $205.64 | $111.30 |
| Rest of GeorgiaGeorgia | $189.15 | $106.33 |
| Hawaii, Guam, HIHawaii | $217.34 | $111.77 |
| IowaIowa | $187.12 | $102.16 |
| IdahoIdaho | $188.26 | $102.83 |
| East St. Louis, ILIllinois | $198.04 | $112.61 |
| Rest of IllinoisIllinois | $194.26 | $109.48 |
| Suburban Chicago, ILIllinois | $210.96 | $115.60 |
| IndianaIndiana | $189.26 | $103.18 |
| KansasKansas | $186.36 | $102.42 |
| KentuckyKentucky | $187.00 | $104.45 |
| New Orleans, LALouisiana | $195.21 | $107.84 |
| Rest of LouisianaLouisiana | $186.75 | $104.58 |
| Metropolitan Boston, MAMassachusetts | $229.43 | $118.57 |
| Rest of MassachusettsMassachusetts | $208.76 | $110.99 |
| Baltimore area, MDMaryland | $214.17 | $114.54 |
| Rest of MarylandMaryland | $203.77 | $109.81 |
| Rest of MaineMaine | $189.20 | $103.78 |
| Southern Maine, MEMaine | $198.56 | $106.54 |
| Detroit, MIMichigan | $201.85 | $112.24 |
| Rest of MichiganMichigan | $191.50 | $106.73 |
| MinnesotaMinnesota | $201.40 | $105.86 |
| Metropolitan Kansas City, MOMissouri | $193.94 | $106.75 |
| Metropolitan St. Louis, MOMissouri | $195.80 | $107.41 |
| Rest of MissouriMissouri | $183.84 | $103.80 |
| MississippiMississippi | $182.22 | $102.27 |
| MontanaMontana | $202.06 | $109.21 |
| North CarolinaNorth Carolina | $191.01 | $104.38 |
| North DakotaNorth Dakota | $198.31 | $105.45 |
| NebraskaNebraska | $188.05 | $102.34 |
| New HampshireNew Hampshire | $206.65 | $109.99 |
| Northern New JerseyNew Jersey | $227.54 | $119.83 |
| Rest of New JerseyNew Jersey | $217.33 | $115.93 |
| New MexicoNew Mexico | $192.48 | $107.34 |
| NevadaNevada | $201.15 | $108.20 |
| NYC suburbs and Long Island, NYNew York | $236.41 | $126.00 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $218.76 | $117.09 |
| Queens, NYNew York | $232.86 | $123.10 |
| Rest of New YorkNew York | $193.64 | $105.43 |
| OhioOhio | $190.74 | $105.96 |
| OklahomaOklahoma | $186.65 | $103.73 |
| Portland, OROregon | $216.02 | $112.86 |
| Rest of OregonOregon | $199.67 | $107.18 |
| Metropolitan Philadelphia, PAPennsylvania | $209.83 | $113.17 |
| Rest of PennsylvaniaPennsylvania | $190.99 | $105.75 |
| Puerto RicoPuerto Rico | $203.42 | $109.54 |
| Rhode IslandRhode Island | $206.94 | $111.02 |
| South CarolinaSouth Carolina | $191.17 | $105.38 |
| South DakotaSouth Dakota | $197.86 | $105.01 |
| TennesseeTennessee | $187.22 | $102.82 |
| Austin, TXTexas | $209.08 | $110.84 |
| Beaumont, TXTexas | $189.84 | $105.34 |
| Brazoria, TXTexas | $200.02 | $108.00 |
| Dallas, TXTexas | $201.23 | $108.75 |
| Fort Worth, TXTexas | $200.01 | $108.45 |
| Galveston, TXTexas | $200.59 | $108.38 |
| Houston, TXTexas | $204.06 | $111.86 |
| Rest of TexasTexas | $194.78 | $106.66 |
| UtahUtah | $193.57 | $106.29 |
| VirginiaVirginia | $197.98 | $106.71 |
| Virgin Islands, VIUnited States Virgin Islands | $203.42 | $109.54 |
| VermontVermont | $197.63 | $105.71 |
| Rest of WashingtonWashington | $208.34 | $110.56 |
| King County, WAWashington | $233.88 | $119.94 |
| WisconsinWisconsin | $192.18 | $103.23 |
| West VirginiaWest Virginia | $187.66 | $106.97 |
| WyomingWyoming | $200.43 | $107.57 |
17264 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.
$180.54
$240.14
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 | $240.14 | 1 |
| AL | $182.95 | 1 |
| AR | $180.54 | 1 |
| AZ | $197.10 | 1 |
| CA | $212.80–$264.13 | 29 |
| CO | $209.84 | 1 |
| CT | $214.79 | 1 |
| DC | $229.60 | 1 |
| DE | $200.19 | 1 |
| FL | $199.51–$217.15 | 3 |
| GA | $189.15–$205.64 | 2 |
| GU | $217.34 | 1 |
| HI | $217.34 | 1 |
| IA | $187.12 | 1 |
| ID | $188.26 | 1 |
| IL | $194.26–$211.40 | 4 |
| IN | $189.26 | 1 |
| KS | $186.36 | 1 |
| KY | $187.00 | 1 |
| LA | $186.75–$195.21 | 2 |
| MA | $208.76–$229.43 | 2 |
| MD | $203.77–$229.60 | 3 |
| ME | $189.20–$198.56 | 2 |
| MI | $191.50–$201.85 | 2 |
| MN | $201.40 | 1 |
| MO | $183.84–$195.80 | 3 |
| MS | $182.22 | 1 |
| MT | $202.06 | 1 |
| NC | $191.01 | 1 |
| ND | $198.31 | 1 |
| NE | $188.05 | 1 |
| NH | $206.65 | 1 |
| NJ | $217.33–$227.54 | 2 |
| NM | $192.48 | 1 |
| NV | $201.15 | 1 |
| NY | $193.64–$236.41 | 5 |
| OH | $190.74 | 1 |
| OK | $186.65 | 1 |
| OR | $199.67–$216.02 | 2 |
| PA | $190.99–$209.83 | 2 |
| PR | $203.42 | 1 |
| RI | $206.94 | 1 |
| SC | $191.17 | 1 |
| SD | $197.86 | 1 |
| TN | $187.22 | 1 |
| TX | $189.84–$209.08 | 8 |
| UT | $193.57 | 1 |
| VA | $197.98–$229.60 | 2 |
| VI | $203.42 | 1 |
| VT | $197.63 | 1 |
| WA | $208.34–$233.88 | 2 |
| WI | $192.18 | 1 |
| WV | $187.66 | 1 |
| WY | $200.43 | 1 |
How the 17264 rate is calculated
Each of 17264’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 · 17264
RVUs × geographic indexes × conversion factor
Work1.94
1.94 RVUs× 1.000 GPCI
Practice expense3.92
3.92 RVUs× 1.000 GPCI
Malpractice0.19
0.19 RVUs× 1.000 GPCI
Adjusted RVUs
6.0500
Conversion factor
$33.4009
Medicare rate
$202.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Connecticut inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,632
- Code
- 17264
- Physician work
- 1.94
- Practice expense
- 3.92
- Malpractice
- 0.19
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.94 | × 1.020 | 1.9788 |
| Practice expense | 3.92 | × 1.077 | 4.2218 |
| Malpractice | 0.19 | × 1.210 | 0.2299 |
| Total RVUs | 6.4305 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Connecticut$214.79
Office: (1.94 × 1.02 + 3.92 × 1.077 + 0.19 × 1.21) × $33.4009 = $214.79
Facility: (1.94 × 1.02 + 1.14 × 1.077 + 0.19 × 1.21) × $33.4009 = $114.78
Payment rules and modifiers for 17264
17264 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 17264
Skin lesion destruction, trunk, arms, or legs; 3.1–4.0 cm
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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 · 17264
Skin lesion destruction, trunk, arms, or legs; 3.1–4.0 cm
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
17264 without 51 · national office
$202.08
Skin lesion destruction, trunk, arms, or legs; 3.1–4.0 cm
17264-51 · Second procedure: 50%
$101.04
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 17264 has changed in Connecticut
17264 · Office / nonfacility
$214.79
Effective 2026-10-01
The base rate is $1.41 lower than on 2025-10-01, moving from $216.20 to $214.79 (0.7%).
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
$216.20changed to$214.79
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.99 changed to 1.94
- Practice expense RVU 4.03 changed to 3.92
- Malpractice RVU 0.21 changed to 0.19
- Work GPCI 1.022 changed to 1.020
- Practice expense GPCI 1.091 changed to 1.077
- Malpractice GPCI 1.207 changed to 1.210
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$222.86changed to$216.20
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.04 changed to 4.03
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$219.22changed to$222.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$226.46changed to$219.22
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.01 changed to 4.04
- Malpractice RVU 0.20 changed to 0.21
- Work GPCI 1.030 changed to 1.022
- Practice expense GPCI 1.102 changed to 1.091
- Malpractice GPCI 1.070 changed to 1.207
January 1, 2023
RVU23A
$229.77changed to$226.46
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.94 changed to 4.01
- Work GPCI 1.037 changed to 1.030
- Practice expense GPCI 1.114 changed to 1.102
- Malpractice GPCI 0.934 changed to 1.070
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$229.41changed to$229.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.89 changed to 3.94
- Malpractice RVU 0.19 changed to 0.20
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$228.42changed to$229.41
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.66 changed to 3.89
- Work GPCI 1.029 changed to 1.037
- Practice expense GPCI 1.113 changed to 1.114
- Malpractice GPCI 1.094 changed to 0.934
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$229.31changed to$228.42
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.59 changed to 3.66
- Malpractice RVU 0.27 changed to 0.19
- Work GPCI 1.021 changed to 1.029
- Practice expense GPCI 1.112 changed to 1.113
- Malpractice GPCI 1.255 changed to 1.094
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$229.16changed to$229.31
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.57 changed to 3.59
- Malpractice RVU 0.29 changed to 0.27
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$226.67changed to$229.16
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.52 changed to 3.57
- Malpractice RVU 0.28 changed to 0.29
- Work GPCI 1.023 changed to 1.021
- Practice expense GPCI 1.117 changed to 1.112
- Malpractice GPCI 1.244 changed to 1.255
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$227.03changed to$226.67
- Conversion factor 35.8043 changed to 35.8887
- Malpractice RVU 0.29 changed to 0.28
- Work GPCI 1.024 changed to 1.023
- Practice expense GPCI 1.121 changed to 1.117
- Malpractice GPCI 1.232 changed to 1.244
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$227.37changed to$227.03
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.53 changed to 3.52
- Malpractice RVU 0.27 changed to 0.29
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$226.24changed to$227.37
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$222.50changed to$226.24
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.43 changed to 3.53
- Malpractice RVU 0.28 changed to 0.27
- Practice expense GPCI 1.116 changed to 1.121
- Malpractice GPCI 1.234 changed to 1.232
Held through RVU15B.
January 1, 2014
RVU14A
$228.05changed to$222.50
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.88 changed to 3.43
- Malpractice RVU 0.29 changed to 0.28
- Practice expense GPCI 1.110 changed to 1.116
- Malpractice GPCI 1.235 changed to 1.234
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $228.05
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $214.79 | $114.78 | RVU26D |
| 2026-07-01 | $214.79 | $114.78 | RVU26C |
| 2026-04-01 | $214.79 | $114.78 | RVU26B |
| 2026-01-01 | $214.79 | $114.78 | RVU26A |
| 2025-10-01 | $216.20 | $136.09 | RVU25D |
| 2025-07-01 | $216.20 | $136.09 | RVU25C |
| 2025-04-01 | $216.20 | $136.09 | RVU25B |
| 2025-01-01 | $216.20 | $136.09 | RVU25A |
| 2024-10-01 | $222.86 | $138.24 | RVU24D |
| 2024-07-01 | $222.86 | $138.24 | RVU24C |
| 2024-04-01 | $222.86 | $138.24 | RVU24B |
| 2024-03-09 | $222.86 | $138.24 | RVU24AR |
| 2024-01-01 | $219.22 | $135.98 | RVU24A |
| 2023-10-01 | $226.46 | $139.07 | RVU23D |
| 2023-07-01 | $226.46 | $139.07 | RVU23C |
| 2023-04-01 | $226.46 | $139.07 | RVU23B |
| 2023-01-01 | $226.46 | $139.07 | RVU23A |
| 2022-10-01 | $229.77 | $139.56 | RVU22D |
| 2022-07-01 | $229.77 | $139.56 | RVU22C |
| 2022-04-01 | $229.77 | $139.56 | RVU22B |
| 2022-01-01 | $229.77 | $139.56 | RVU22A |
| 2021-10-01 | $229.41 | $140.39 | RVU21D |
| 2021-07-01 | $229.41 | $140.39 | RVU21C |
| 2021-04-01 | $229.41 | $140.39 | RVU21B |
| 2021-01-01 | $229.41 | $140.39 | RVU21A |
| 2020-10-01 | $228.42 | $146.07 | RVU20D |
| 2020-07-01 | $228.42 | $146.07 | RVU20C |
| 2020-04-01 | $228.42 | $146.07 | RVU20B |
| 2020-01-01 | $228.42 | $146.07 | RVU20A |
| 2019-10-01 | $229.31 | $151.16 | RVU19D |
| 2019-07-01 | $229.31 | $151.16 | RVU19C |
| 2019-04-01 | $229.31 | $151.16 | RVU19B |
| 2019-01-01 | $229.31 | $151.16 | RVU19A |
| 2018-10-01 | $229.16 | $153.90 | RVU18D |
| 2018-07-01 | $229.16 | $153.90 | RVU18C |
| 2018-04-01 | $229.16 | $153.90 | RVU18B |
| 2018-01-01 | $229.16 | $153.90 | RVU18AR1 |
| 2017-10-01 | $226.67 | $152.91 | RVU17D |
| 2017-07-01 | $226.67 | $152.91 | RVU17C |
| 2017-04-01 | $226.67 | $152.91 | RVU17B |
| 2017-01-01 | $226.67 | $152.91 | RVU17A |
| 2016-10-01 | $227.03 | $153.18 | RVU16D |
| 2016-07-01 | $227.03 | $153.18 | RVU16C |
| 2016-04-01 | $227.03 | $153.18 | RVU16B |
| 2016-01-01 | $227.03 | $153.18 | RVU16A |
| 2015-10-01 | $227.37 | $152.85 | RVU15D |
| 2015-07-01 | $227.37 | $152.85 | RVU15C |
| 2015-04-01 | $226.24 | $152.09 | RVU15B |
| 2015-01-01 | $226.24 | $152.09 | RVU15A |
| 2014-10-01 | $222.50 | $150.94 | RVU14D |
| 2014-07-01 | $222.50 | $150.94 | RVU14C |
| 2014-04-01 | $222.50 | $150.94 | RVU14B |
| 2014-01-01 | $222.50 | $150.94 | RVU14A |
| 2013-10-01 | $228.05 | $150.63 | RVU13D |
| 2013-07-01 | $228.05 | $150.63 | RVU13C |
| 2013-04-01 | $228.05 | $150.63 | RVU13B |
| 2013-01-01 | $228.05 | $150.63 | RVU13AR |
Where the Connecticut rate applies
Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.
- Ansonia
- Ball Pond
- Baltic
- Bantam
- Bethel
- Bethlehem Village
- Bigelow Corners
- Blue Hills
17264 billing questions
How is this code distinguished from 17263 or 17266?
The anatomic group is the same, but this code is for a lesion measuring 3.1–4.0 cm. Code 17263 is for the next smaller size range, and 17266 is for a lesion larger than 4.0 cm.
Can this code be used for a lesion on the face or hand?
No. This code is limited to lesions on the trunk, arms, or legs; other anatomic groups have separate codes even when the lesion diameter is the same.
What documentation supports the size selection?
Record the malignant diagnosis, precise anatomic site, pretreatment lesion diameter, and the destructive treatment performed. The documented diameter must fall within the 3.1–4.0 cm range.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How does CMS treat other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
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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