CPT code 96573: Photodynamic therapy, includes agent application2026 Medicare rate & RVUs

Medicare pays $217.44 for 96573 nationally in the office. Local office rates run $188.76–$307.73.

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

What 96573 covers

Code 96573 describes photodynamic treatment of premalignant lesions of the skin or adjacent mucosa using an applied photosensitizer and external light. Dermatologists commonly use it for actinic keratoses, such as lesions on the face or scalp. A physician or other qualified health care professional performs the service in an office or outpatient setting; the code includes application of the photosensitizing agent when performed.

Report the service per treatment day, rather than per lesion or light-treatment interval. Documentation should identify the treated sites, the photosensitizer application when performed, and the light treatment. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; 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.

Where 96573 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96573 rates by state

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

How the 96573 rate is calculated

Each of 96573’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 96573

The CMS indicators that decide how 96573 is paid alongside other services.

96573 compared with similar codes

How to choose

96567Photodynamic therapyIncident-to treatment

Use 96573 when the service includes application of the photosensitizing agent. Code 96567 represents photodynamic treatment without that included agent-application element.

96574Lesion debridementFor photodynamic therapy

Code 96574 describes photodynamic treatment that also includes debridement of premalignant lesions; 96573 does not describe that debridement service.

17000Premalignant lesion destructionFirst lesion

Code 17000 is for cryosurgical destruction of a first premalignant lesion. Code 96573 is photodynamic treatment using a photosensitizer and external light.

Codes related to 96573

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

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