CPT code 96567: Photodynamic therapy, incident-to treatment2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $129.04 for 96567 in the office.

Check a contract rate as a % of Medicare · 96567 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96567 covers

This service treats premalignant lesions, commonly actinic keratoses on sun-damaged skin such as the face or scalp, with a photosensitizing agent followed by external illumination. The treatment is typically furnished in a dermatology office, with clinical staff performing the service under physician supervision. The light activates the agent in the treated area to damage the targeted abnormal cells.

Report one unit for each treatment, rather than one unit per lesion. Documentation should identify the treated area, photosensitizing agent, light treatment, and physician supervision. Under the CMS rule for this code, Medicare billing is limited to performance under physician supervision as an incident-to service. When a physician or other qualified health care professional performs the photodynamic treatment, distinguish that service from this staff-performed code and consider 96573. Separate lesion debridement performed to prepare for photodynamic therapy may be reported with 96574 when supported by the documentation.

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 South Dakota compares for 96567

Across 109 of 109 payment localities, the office rate for 96567 runs from $110.92 in Arkansas to $186.09 in San Benito County, CA. South Dakota pays $129.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96567 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 96567 in every payment locality

How the 96567 rate is calculated

Each of 96567’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.

Payment rules and modifiers for 96567

The CMS indicators that decide how 96567 is paid alongside other services.

Codes related to 96567

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

How 96567 has changed in South Dakota

Price 96567 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates