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CPT code 95056: Phototesting, skin response to light2026 Medicare rate & RVUs in Washington, DC area

Reports diagnostic skin testing with controlled light exposure to evaluate suspected photosensitivity, such as a light-triggered rash or other photodermatosis.

CMS RVU26DEffective Oct 1, 2026One payment locality17 Medicare services in 2024

In Washington, DC area, Medicare pays $60.94 for 95056 in the office.

$60.94Office (non-facility)
Not available in this settingHospital or facility
+17.7%vs the national office rate ($51.77)

Check a contract rate as a % of Medicare · 95056 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 95056 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 95056 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 95056 covers

Phototesting evaluates how skin responds to controlled exposure to ultraviolet or visible light. Dermatologists and clinicians experienced in photodermatology use it when a patient develops a rash or other skin reaction in sun-exposed areas and the cause may be abnormal light sensitivity. The test can help characterize the response to light as part of evaluating a suspected photodermatosis.

Choose this code for direct light-response testing, not for applying allergens and then exposing the test site to light. Document the clinical reason for testing, the light-testing method and exposures performed, and the resulting skin response. CMS identifies this as an incident-to service: it is billed only when performed under physician supervision.

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 Washington, DC area compares for 95056

Across 109 of 109 payment localities, the office rate for 95056 runs from $44.24 in Arkansas to $74.05 in San Benito County, CA. Washington, DC area pays $60.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

95056 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$60.94
  2. Los Angeles, CA · California$60.90−$0.04
  3. Miami, FL · Florida$54.89−$6.05
  4. Chicago, IL · Illinois$52.89−$8.05
  5. Manhattan, NY · New York$60.44−$0.50
  6. Alaska · Alaska$54.79−$6.15
  7. Alabama · Alabama$45.09−$15.85

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

95056 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$44.24—
ArizonaArizona$50.09—
Bakersfield, CACalifornia$56.42—
Chico, CACalifornia$56.37—
El Centro, CACalifornia$56.37—
Fresno, CACalifornia$56.37—
Hanford, CACalifornia$56.37—
Madera, CACalifornia$56.37—

95056 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.

$44.24

$65.21

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95056 office rate range by state
State / territoryOffice rate rangeLocalities
AK$54.791
AL$45.091
AR$44.241
AZ$50.091
CA$56.37–$74.0529
CO$54.901
CT$55.851
DC$60.941
DE$51.091
FL$49.86–$54.893
GA$46.38–$52.722
GU$58.491
HI$58.491
IA$47.021
ID$47.331
IL$47.70–$53.674
IN$47.701
KS$46.531
KY$46.041
LA$45.87–$48.852
MA$54.34–$61.612
MD$52.33–$60.943
ME$47.43–$51.062
MI$47.41–$50.442
MN$52.781
MO$44.70–$49.323
MS$44.491
MT$51.771
NC$48.111
ND$51.371
NE$47.421
NH$53.781
NJ$56.54–$59.992
NM$47.661
NV$51.711
NY$49.02–$62.005
OH$47.331
OK$46.151
OR$51.37–$57.272
PA$47.54–$54.002
PR$52.321
RI$53.391
SC$47.791
SD$51.331
TN$46.811
TX$47.12–$54.668
UT$48.641
VA$50.71–$60.942
VI$52.321
VT$50.931
WA$54.32–$63.252
WI$49.161
WV$45.361
WY$51.601

See 95056 in every payment locality

How the 95056 rate is calculated

Each of 95056’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 · 95056

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense1.53

1.53 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.5500

Conversion factor

$33.4009

Medicare rate

$51.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,466

Code
95056
Physician work
0.00
Practice expense
1.53
Malpractice
0.02

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 95056 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0540.0000
Practice expense1.53× 1.1781.8023
Malpractice0.02× 1.1130.0223
Total RVUs1.8246
Conversion factor× 33.4009

Office rate, Washington, DC area$60.94

Office: (0 × 1.054 + 1.53 × 1.178 + 0.02 × 1.113) × $33.4009 = $60.94

Open 95056 in the RVU calculator

Payment rules and modifiers for 95056

The CMS indicators that decide how 95056 is paid alongside other services.

CMS payment indicators · 95056

Phototesting, skin response to light

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical5Incident-to service.

Codes related to 95056

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

Codes related to 95056
CodeHow it relatesOffice range, Washington, DC area
Same family
95052Photopatch testing, light-dependent contact allergyPhotopatch testing evaluates contact-allergen reactions associated with light exposure.$7.06
Used instead
95044Patch testing, each separate patch testUsed for patch testing when evaluating delayed contact reactions without light testing.$5.88
95004Allergy skin prick test, percutaneous, immediate reaction, per testPercutaneous allergen testing addresses immediate allergen sensitivity, rather than a light-induced skin response.$4.26

How 95056 has changed in Washington, DC area

95056 · Office / nonfacility

$60.94

Effective 2026-10-01

The base rate is $0.35 lower than on 2025-10-01, moving from $61.29 to $60.94 (0.6%).

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

    $61.29changed to$60.94

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.57 changed to 1.53
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $62.28changed to$61.29

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.55 changed to 1.57

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $61.26changed to$62.28

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $62.54changed to$61.26

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.50 changed to 1.55
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $62.04changed to$62.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.44 changed to 1.50
    • Malpractice RVU 0.01 changed to 0.02
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $60.83changed to$62.04

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.40 changed to 1.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $57.75changed to$60.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.30 changed to 1.40
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $56.93changed to$57.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.29 changed to 1.30
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $56.43changed to$56.93

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.28 changed to 1.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $54.08changed to$56.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.24 changed to 1.28
    • Malpractice RVU 0.01 changed to 0.02
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $53.98changed to$54.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.23 changed to 1.24
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $54.15changed to$53.98

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.24 changed to 1.23
    • Malpractice RVU 0.01 changed to 0.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $53.88changed to$54.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $52.10changed to$53.88

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.20 changed to 1.24
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $56.63changed to$52.10

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.38 changed to 1.20
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $56.63

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$60.94Not available in this settingRVU26D
2026-07-01$60.94Not available in this settingRVU26C
2026-04-01$60.94Not available in this settingRVU26B
2026-01-01$60.94Not available in this settingRVU26A
2025-10-01$61.29Not available in this settingRVU25D
2025-07-01$61.29Not available in this settingRVU25C
2025-04-01$61.29Not available in this settingRVU25B
2025-01-01$61.29Not available in this settingRVU25A
2024-10-01$62.28Not available in this settingRVU24D
2024-07-01$62.28Not available in this settingRVU24C
2024-04-01$62.28Not available in this settingRVU24B
2024-03-09$62.28Not available in this settingRVU24AR
2024-01-01$61.26Not available in this settingRVU24A
2023-10-01$62.54Not available in this settingRVU23D
2023-07-01$62.54Not available in this settingRVU23C
2023-04-01$62.54Not available in this settingRVU23B
2023-01-01$62.54Not available in this settingRVU23A
2022-10-01$62.04Not available in this settingRVU22D
2022-07-01$62.04Not available in this settingRVU22C
2022-04-01$62.04Not available in this settingRVU22B
2022-01-01$62.04Not available in this settingRVU22A
2021-10-01$60.83Not available in this settingRVU21D
2021-07-01$60.83Not available in this settingRVU21C
2021-04-01$60.83Not available in this settingRVU21B
2021-01-01$60.83Not available in this settingRVU21A
2020-10-01$57.75Not available in this settingRVU20D
2020-07-01$57.75Not available in this settingRVU20C
2020-04-01$57.75Not available in this settingRVU20B
2020-01-01$57.75Not available in this settingRVU20A
2019-10-01$56.93Not available in this settingRVU19D
2019-07-01$56.93Not available in this settingRVU19C
2019-04-01$56.93Not available in this settingRVU19B
2019-01-01$56.93Not available in this settingRVU19A
2018-10-01$56.43Not available in this settingRVU18D
2018-07-01$56.43Not available in this settingRVU18C
2018-04-01$56.43Not available in this settingRVU18B
2018-01-01$56.43Not available in this settingRVU18AR1
2017-10-01$54.08Not available in this settingRVU17D
2017-07-01$54.08Not available in this settingRVU17C
2017-04-01$54.08Not available in this settingRVU17B
2017-01-01$54.08Not available in this settingRVU17A
2016-10-01$53.98Not available in this settingRVU16D
2016-07-01$53.98Not available in this settingRVU16C
2016-04-01$53.98Not available in this settingRVU16B
2016-01-01$53.98Not available in this settingRVU16A
2015-10-01$54.15Not available in this settingRVU15D
2015-07-01$54.15Not available in this settingRVU15C
2015-04-01$53.88Not available in this settingRVU15B
2015-01-01$53.88Not available in this settingRVU15A
2014-10-01$52.10Not available in this settingRVU14D
2014-07-01$52.10Not available in this settingRVU14C
2014-04-01$52.10Not available in this settingRVU14B
2014-01-01$52.10Not available in this settingRVU14A
2013-10-01$56.63Not available in this settingRVU13D
2013-07-01$56.63Not available in this settingRVU13C
2013-04-01$56.63Not available in this settingRVU13B
2013-01-01$56.63Not available in this settingRVU13AR

Price 95056 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

95056 billing questions

How does phototesting differ from photopatch testing?

Phototesting assesses the skin’s response to light exposure. Photopatch testing (95052) evaluates whether a contact allergen causes a reaction when combined with light exposure.

Can this code be used for ordinary patch testing?

No. Ordinary patch testing for delayed contact reactions is reported with 95044; 95056 is for direct testing of skin response to light.

Who may perform the service for Medicare billing?

CMS identifies 95056 as an incident-to service and permits billing only when it is performed under physician supervision.

What documentation supports reporting 95056?

Document the suspected photosensitivity, why light testing was performed, the testing method and exposures, and the observed skin response.

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 95056PPRRVU2026_Oct_nonQPP.csv, line 12,466 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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