Destruct premalg les 2-14
CPT code 17003 is used when a healthcare provider destroys premalignant skin lesions (like actinic keratoses) using methods such as freezing, burning, or chemical treatment. This code specifically covers the second through fourteenth lesions treated in the same session.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Always bill 17003 with the correct number of units (1 unit per lesion for lesions 2-14). For example, if treating 8 total lesions, report 17000 x1 and 17003 x7.
Impact: Each correctly billed unit generates $6.47 (non-facility); billing 7 units instead of accidentally billing only 1 unit means $45.29 vs $6.47, a difference of $38.82
Do not bill 17003 for more than 13 units per session. For 15 or more premalignant lesions, use code 17004 instead of continuing with 17003.
Impact: Using 17004 for 15+ lesions reimburses at appropriate rate and prevents audit flags for excessive units; incorrect coding may trigger automatic denial or prepayment review
Document the exact number, location, and treatment method for each lesion destroyed. Include lesion size and specific anatomic site (e.g., 'left forearm 3mm AK, right temple 4mm AK').
Impact: Detailed documentation supports medical necessity and reduces denial risk by 60-70%; prevents downcoding from 17003 to less specific codes or complete denial
Verify facility vs non-facility status before submission. The reimbursement difference is substantial: $6.47 non-facility vs $1.94 facility.
Impact: Incorrect place of service coding results in $4.53 payment difference per unit; for 10 units this equals $45.30 underpayment or potential recoupment
Do not bill 17003 on the same date as destruction of malignant lesions (codes 17260-17286) without appropriate modifier, as these may bundle under NCCI edits.
Impact: Unbundling violations can result in complete denial of 17003 units; proper modifier 59 usage preserves 100% of expected reimbursement
Link appropriate ICD-10 diagnosis codes for premalignant lesions (L57.0 for actinic keratosis, D22.x for dysplastic nevus) to support medical necessity.
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