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

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 Delaware, Medicare pays $136.63 for 96920 in the office and $40.93 when it’s performed in a hospital or facility.

$136.63Office (non-facility)
$40.93Hospital or facility
−1.0%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 Delaware
  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 Delaware 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. Delaware pays $136.63. The RVUs are the same everywhere; the geographic indexes change the dollars.

96920 in Delaware vs other payment areas
  1. Delaware · this page$136.63
  2. Los Angeles, CA · California$158.65+$22.02
  3. Washington, DC area · District of Columbia$159.06+$22.43
  4. Miami, FL · Florida$144.48+$7.85
  5. Chicago, IL · Illinois$140.41+$3.78
  6. Manhattan, NY · New York$158.21+$21.58
  7. Alaska · Alaska$157.99+$21.36

Other areas in Delaware 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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 96920 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.81× 1.0050.8140
Practice expense3.28× 0.9883.2406
Malpractice0.04× 0.8990.0360
Total RVUs4.0907
Conversion factor× 33.4009

Office rate, Delaware$136.63

Office: (0.81 × 1.005 + 3.28 × 0.988 + 0.04 × 0.899) × $33.4009 = $136.63

Facility: (0.81 × 1.005 + 0.38 × 0.988 + 0.04 × 0.899) × $33.4009 = $40.93

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, Delaware
Same family
96921Excimer laser, 250–500 square centimetersExcimer laser treatment for a total treated area of 250–500 square centimeters.$146.57
96922Excimer laser, more than 500 sq cmExcimer laser treatment for a total treated area greater than 500 square centimeters.$174.40
Used instead
96910Phototherapy, tar or petrolatum with UVBPhotochemotherapy using tar or petrolatum with ultraviolet treatment is a different psoriasis treatment approach.$113.46
96912PUVA therapy, psoralen plus UVAPUVA photochemotherapy is a different treatment modality for psoriasis.$95.97

How 96920 has changed in Delaware

96920 · Office / nonfacility

$136.63

Effective 2026-10-01

The base rate is $0.50 higher than on 2025-10-01, moving from $136.13 to $136.63 (0.4%).

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

    $136.13changed to$136.63

    • 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 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $154.79changed to$136.13

    • 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

    $152.26changed to$154.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $159.27changed to$152.26

    • 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 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $164.33changed to$159.27

    • 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 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $168.90changed to$164.33

    • 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

    $169.25changed to$168.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.41 changed to 3.56
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $170.12changed to$169.25

    • 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 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $171.03changed to$170.12

    • 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

    $161.77changed to$171.03

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.20 changed to 3.46
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $161.38changed to$161.77

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.18 changed to 3.20
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $161.19changed to$161.38

    • 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

    $160.38changed to$161.19

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $157.85changed to$160.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.09 changed to 3.18
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $163.76changed to$157.85

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.47 changed to 3.09
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $163.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$136.63$40.93RVU26D
2026-07-01$136.63$40.93RVU26C
2026-04-01$136.63$40.93RVU26B
2026-01-01$136.63$40.93RVU26A
2025-10-01$136.13$49.17RVU25D
2025-07-01$136.13$49.17RVU25C
2025-04-01$136.13$49.17RVU25B
2025-01-01$136.13$49.17RVU25A
2024-10-01$154.79$62.66RVU24D
2024-07-01$154.79$62.66RVU24C
2024-04-01$154.79$62.66RVU24B
2024-03-09$154.79$62.66RVU24AR
2024-01-01$152.26$61.64RVU24A
2023-10-01$159.27$63.72RVU23D
2023-07-01$159.27$63.72RVU23C
2023-04-01$159.27$63.72RVU23B
2023-01-01$159.27$63.72RVU23A
2022-10-01$164.33$64.94RVU22D
2022-07-01$164.33$64.94RVU22C
2022-04-01$164.33$64.94RVU22B
2022-01-01$164.33$64.94RVU22A
2021-10-01$168.90$65.48RVU21D
2021-07-01$168.90$65.48RVU21C
2021-04-01$168.90$65.48RVU21B
2021-01-01$168.90$65.48RVU21A
2020-10-01$169.25$68.65RVU20D
2020-07-01$169.25$68.65RVU20C
2020-04-01$169.25$68.65RVU20B
2020-01-01$169.25$68.65RVU20A
2019-10-01$170.12$69.49RVU19D
2019-07-01$170.12$69.49RVU19C
2019-04-01$170.12$69.49RVU19B
2019-01-01$170.12$69.49RVU19A
2018-10-01$171.03$69.78RVU18D
2018-07-01$171.03$69.78RVU18C
2018-04-01$171.03$69.78RVU18B
2018-01-01$171.03$69.78RVU18AR1
2017-10-01$161.77$70.17RVU17D
2017-07-01$161.77$70.17RVU17C
2017-04-01$161.77$70.17RVU17B
2017-01-01$161.77$70.17RVU17A
2016-10-01$161.38$69.47RVU16D
2016-07-01$161.38$69.47RVU16C
2016-04-01$161.38$69.47RVU16B
2016-01-01$161.38$69.47RVU16A
2015-10-01$161.19$69.31RVU15D
2015-07-01$161.19$69.31RVU15C
2015-04-01$160.38$68.96RVU15B
2015-01-01$160.38$68.96RVU15A
2014-10-01$157.85$68.23RVU14D
2014-07-01$157.85$68.23RVU14C
2014-04-01$157.85$68.23RVU14B
2014-01-01$157.85$68.23RVU14A
2013-10-01$163.76$67.51RVU13D
2013-07-01$163.76$67.51RVU13C
2013-04-01$163.76$67.51RVU13B
2013-01-01$163.76$67.51RVU13AR

Price 96920 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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