CPT code 17004: Premalignant lesion destruction2026 Medicare rate & RVUs in Oklahoma

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, 20261 payment locality852.8K Medicare services in 2024

Medicare pays $149.24 for 17004 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.

$149.24Office (non-facility)
$78.26Hospital or facility

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 9 sections
  1. Rate in Oklahoma
  2. What 17004 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

17004 in Oklahoma

17004 office and facility rates by payment locality
Payment localityOfficeFacility
Oklahoma$149.24$78.26

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

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

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

17004 compared with similar codes

Compare codes · National

5 codes, side by side

  • 17004

    Premalignant lesion destruction1.34 wRVU

    $162.33

  • 17000

    Premalignant lesion destruction0.59 wRVU

    $66.47−$95.86

  • 17003

    Actinic keratosis destruction0.04 wRVU

    $6.35−$155.98

  • 17110

    Benign lesion destruction0.68 wRVU

    $111.22−$51.11

  • 17260

    Skin lesion destruction0.94 wRVU

    $96.86−$65.47

How to choose

17000Premalignant lesion destruction
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 destruction
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 destruction
17110 covers benign lesions such as common warts and molluscum. Actinic keratoses and other premalignant lesions belong in the 17000–17004 series.
17260Skin lesion destruction
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
RVUs for 17004PPRRVU2026_Oct_nonQPP.csv, line 1,621 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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