CPT code 96920: Excimer laser, under 250 sq cm2026 Medicare rate & RVUs

Reports excimer laser treatment of psoriasis when the total skin area treated during the session is less than 250 square centimeters.

CMS RVU26DEffective Oct 1, 2026109 payment localities60.5K Medicare services in 2024

Medicare pays $137.95 for 96920 nationally in the office and $41.08 in a hospital or facility. Local office rates run $121.85–$188.73.

Medicare rate · 96920

Excimer laser, under 250 sq cm

Office or facility?

Work RVUs
0.81
Total RVUs
4.13
Global days
000

National rate · 2026

$137.95

Office setting, before claim adjustments.

See every locality for 96920 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 96920 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 96920 covers

This service uses an excimer laser to deliver targeted ultraviolet treatment to psoriasis plaques, commonly in patients with localized disease. Dermatologists and other qualified clinicians may perform it in an office setting; typical treatment sites include discrete plaques on the elbows, knees, or scalp. The laser targets affected skin rather than exposing the whole body to phototherapy.

Choose this code when the total psoriasis area treated during the session is under 250 square centimeters; select the sibling area tier when the treated area is larger. Document the sites and measured area treated, along with the treatment performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and 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 96920 pays more and less

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

109 payment localities

$121.85 to $188.73

$121.85$155.29$188.73
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

96920 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$123.67$38.92
Alaska$157.99$54.84
Arizona$134.36$40.50
Arkansas$121.85$38.65
Atlanta, GA$140.05$41.64
Austin, TX$144.20$41.72
Bakersfield, CA$148.45$42.29
Baltimore area, MD$146.69$42.76
Beaumont, TX$127.99$39.85
Brazoria, TX$136.88$40.89

96920 rates by state

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

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.

$121.85

$168.52

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

View every state and territory as a table
96920 office rate range by state
State / territoryOffice rate rangeLocalities
AK$157.991
AL$123.671
AR$121.851
AZ$134.361
CA$148.30–$188.7329
CO$144.991
CT$147.201
DC$159.061
DE$136.631
FL$133.80–$144.483
GA$126.37–$140.052
GU$152.391
HI$152.391
IA$127.831
ID$128.481
IL$129.17–$142.124
IN$129.261
KS$126.771
KY$125.671
LA$125.29–$131.662
MA$143.91–$160.162
MD$139.42–$159.063
ME$128.68–$136.472
MI$128.59–$135.032
MN$140.181
MO$122.79–$132.693
MS$122.371
MT$137.941
NC$130.121
ND$137.151
NE$128.681
NH$142.271
NJ$149.24–$157.272
NM$129.121
NV$137.831
NY$132.07–$161.535
OH$128.431
OK$125.931
OR$137.11–$150.202
PA$128.89–$143.182
PR$139.131
RI$141.931
SC$129.421
SD$137.061
TN$127.361
TX$127.99–$144.208
UT$131.241
VA$135.69–$159.062
VI$139.131
VT$136.191
WA$143.78–$163.922
WI$132.421
WV$124.171
WY$137.601

How the 96920 rate is calculated

Each of 96920’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 · 96920

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.81

0.81 RVUs× 1.000 GPCI

Practice expense3.28

3.28 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

4.1300

Conversion factor

$33.4009

Medicare rate

$137.95

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

Payment rules and modifiers for 96920

The CMS indicators that decide how 96920 is paid alongside other services.

CMS payment indicators · 96920

Excimer laser, under 250 sq cm

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

96920 without 51 · national office

$137.95

Excimer laser, under 250 sq cm

96920-51 · Second procedure: 50%

$68.98

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

96920 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 96920

    Excimer laser, under 250 sq cm0.81 wRVU

    $137.95

  • 96921

    Excimer laser, 250–500 square centimeters0.88 wRVU

    $147.97+$10.02

  • 96922

    Excimer laser, more than 500 sq cm1.12 wRVU

    $176.02+$38.07

  • 96910

    Phototherapy, tar or petrolatum with UVB0 wRVU

    $114.90−$23.05

  • 96912

    PUVA therapy, psoralen plus UVA0 wRVU

    $97.20−$40.75

How to choose

96921Excimer laser250–500 square centimeters
Use 96920 for less than 250 square centimeters treated. Code 96921 applies when the total treated area is 250–500 square centimeters.
96922Excimer laserMore than 500 sq cm
Use 96920 for less than 250 square centimeters treated. Code 96922 applies when the total treated area exceeds 500 square centimeters.
96910PhototherapyTar or petrolatum with UVB
Code 96910 describes photochemotherapy with tar or petrolatum and ultraviolet treatment; 96920 is for targeted excimer laser treatment of psoriasis.
96912PUVA therapyPsoralen plus UVA
Code 96912 is PUVA photochemotherapy. Choose 96920 when psoriasis plaques are treated with an excimer laser instead.

96920 billing questions

How do I choose between 96920, 96921, and 96922?

Use the total psoriasis area treated during the session: 96920 is for less than 250 square centimeters, 96921 for 250–500, and 96922 for more than 500.

Does the number of plaques determine the code?

No. Select the code by the total area treated, not by the number of plaques or laser applications. Document the treated sites and area.

Can I report more than one area tier for the same session?

Select the single tier that matches the total area treated during that session; the tiers distinguish the treatment-area ranges.

Does modifier 50 apply when plaques are on both sides of the body?

No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

What same-day care is included, and can an assistant be paid?

The 0-day global period includes same-day preoperative and postoperative care. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

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 96920PPRRVU2026_Oct_nonQPP.csv, line 12,830 (RVU26D)

Open CMS sourceHow we calculate rates

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