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

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, 2026One payment locality60.5K Medicare services in 2024

In Connecticut, Medicare pays $147.20 for 96920 in the office and $42.88 when it’s performed in a hospital or facility.

$147.20Office (non-facility)
$42.88Hospital or facility
+6.7%vs the national office rate ($137.95)

Check a contract rate as a % of Medicare · 96920 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 96920 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 96920 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 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.

How Connecticut compares for 96920

Across 109 of 109 payment localities, the office rate for 96920 runs from $121.85 in Arkansas to $188.73 in San Benito County, CA. Connecticut pays $147.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

96920 in Connecticut vs other payment areas
  1. Connecticut · this page$147.20
  2. Los Angeles, CA · California$158.65+$11.45
  3. Washington, DC area · District of Columbia$159.06+$11.86
  4. Miami, FL · Florida$144.48−$2.72
  5. Chicago, IL · Illinois$140.41−$6.79
  6. Manhattan, NY · New York$158.21+$11.01
  7. Alaska · Alaska$157.99+$10.79

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

96920 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$123.67$38.92
ArkansasArkansas$121.85$38.65
ArizonaArizona$134.36$40.50
Bakersfield, CACalifornia$148.45$42.29
Chico, CACalifornia$148.30$42.14
El Centro, CACalifornia$148.31$42.15
Fresno, CACalifornia$148.30$42.14
Hanford, CACalifornia$148.30$42.14

96920 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.

$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

See 96920 in every payment locality

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.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,830

Code
96920
Physician work
0.81
Practice expense
3.28
Malpractice
0.04

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 96920 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.81× 1.0200.8262
Practice expense3.28× 1.0773.5326
Malpractice0.04× 1.2100.0484
Total RVUs4.4072
Conversion factor× 33.4009

Office rate, Connecticut$147.20

Office: (0.81 × 1.02 + 3.28 × 1.077 + 0.04 × 1.21) × $33.4009 = $147.20

Facility: (0.81 × 1.02 + 0.38 × 1.077 + 0.04 × 1.21) × $33.4009 = $42.88

Open 96920 in the RVU calculator

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

Codes related to 96920

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

Codes related to 96920
CodeHow it relatesOffice range, Connecticut
Same family
96921Excimer laser, 250–500 square centimetersExcimer laser treatment for a total treated area of 250–500 square centimeters.$157.86
96922Excimer laser, more than 500 sq cmExcimer laser treatment for a total treated area greater than 500 square centimeters.$187.67
Used instead
96910Phototherapy, tar or petrolatum with UVBPhotochemotherapy using tar or petrolatum with ultraviolet treatment is a different psoriasis treatment approach.$123.84
96912PUVA therapy, psoralen plus UVAPUVA photochemotherapy is a different treatment modality for psoriasis.$104.77

How 96920 has changed in Connecticut

96920 · Office / nonfacility

$147.20

Effective 2026-10-01

The base rate is $0.37 lower than on 2025-10-01, moving from $147.57 to $147.20 (0.3%).

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

    $147.57changed to$147.20

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.83 changed to 0.81
    • Practice expense RVU 3.36 changed to 3.28
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $167.15changed to$147.57

    • Conversion factor 33.2875 changed to 32.3465
    • Work RVU 1.15 changed to 0.83
    • Practice expense RVU 3.47 changed to 3.36
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $164.42changed to$167.15

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $171.55changed to$164.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.48 changed to 3.47
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $176.66changed to$171.55

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.47 changed to 3.48
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $181.62changed to$176.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.56 changed to 3.47

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $181.65changed to$181.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.41 changed to 3.56
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $182.49changed to$181.65

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.43 changed to 3.41
    • Malpractice RVU 0.06 changed to 0.05
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $183.49changed to$182.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.46 changed to 3.43

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $173.18changed to$183.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.20 changed to 3.46
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.44changed to$173.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.18 changed to 3.20
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $172.18changed to$172.44

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.04 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $171.32changed to$172.18

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $167.49changed to$171.32

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.09 changed to 3.18
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $172.79changed to$167.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.47 changed to 3.09
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $172.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$147.20$42.88RVU26D
2026-07-01$147.20$42.88RVU26C
2026-04-01$147.20$42.88RVU26B
2026-01-01$147.20$42.88RVU26A
2025-10-01$147.57$51.94RVU25D
2025-07-01$147.57$51.94RVU25C
2025-04-01$147.57$51.94RVU25B
2025-01-01$147.57$51.94RVU25A
2024-10-01$167.15$65.83RVU24D
2024-07-01$167.15$65.83RVU24C
2024-04-01$167.15$65.83RVU24B
2024-03-09$167.15$65.83RVU24AR
2024-01-01$164.42$64.75RVU24A
2023-10-01$171.55$66.98RVU23D
2023-07-01$171.55$66.98RVU23C
2023-04-01$171.55$66.98RVU23B
2023-01-01$171.55$66.98RVU23A
2022-10-01$176.66$68.33RVU22D
2022-07-01$176.66$68.33RVU22C
2022-04-01$176.66$68.33RVU22B
2022-01-01$176.66$68.33RVU22A
2021-10-01$181.62$68.90RVU21D
2021-07-01$181.62$68.90RVU21C
2021-04-01$181.62$68.90RVU21B
2021-01-01$181.62$68.90RVU21A
2020-10-01$181.65$71.99RVU20D
2020-07-01$181.65$71.99RVU20C
2020-04-01$181.65$71.99RVU20B
2020-01-01$181.65$71.99RVU20A
2019-10-01$182.49$72.68RVU19D
2019-07-01$182.49$72.68RVU19C
2019-04-01$182.49$72.68RVU19B
2019-01-01$182.49$72.68RVU19A
2018-10-01$183.49$73.00RVU18D
2018-07-01$183.49$73.00RVU18C
2018-04-01$183.49$73.00RVU18B
2018-01-01$183.49$73.00RVU18AR1
2017-10-01$173.18$73.36RVU17D
2017-07-01$173.18$73.36RVU17C
2017-04-01$173.18$73.36RVU17B
2017-01-01$173.18$73.36RVU17A
2016-10-01$172.44$72.50RVU16D
2016-07-01$172.44$72.50RVU16C
2016-04-01$172.44$72.50RVU16B
2016-01-01$172.44$72.50RVU16A
2015-10-01$172.18$72.28RVU15D
2015-07-01$172.18$72.28RVU15C
2015-04-01$171.32$71.92RVU15B
2015-01-01$171.32$71.92RVU15A
2014-10-01$167.49$71.14RVU14D
2014-07-01$167.49$71.14RVU14C
2014-04-01$167.49$71.14RVU14B
2014-01-01$167.49$71.14RVU14A
2013-10-01$172.79$70.45RVU13D
2013-07-01$172.79$70.45RVU13C
2013-04-01$172.79$70.45RVU13B
2013-01-01$172.79$70.45RVU13AR

Price 96920 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

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)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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