CPT code 96921: Excimer laser, 250–500 square centimeters2026 Medicare rate & RVUs

Targeted excimer laser treatment for psoriasis is reported when the total skin area treated in a session measures 250–500 square centimeters.

CMS RVU26DEffective Oct 1, 2026109 payment localities21.4K Medicare services in 2024

Medicare pays $147.97 for 96921 nationally in the office and $46.76 in a hospital or facility. Local office rates run $130.79–$202.40.

Medicare rate · 96921

Excimer laser, 250–500 square centimeters

Office or facility?

Work RVUs
0.88
Total RVUs
4.43
Global days
000

National rate · 2026

$147.97

Office setting, before claim adjustments.

See every locality for 96921 →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 96921 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 96921 covers

This service uses an excimer laser to deliver targeted ultraviolet light to psoriasis plaques, limiting exposure of surrounding uninvolved skin. Dermatologists and other qualified practitioners typically perform the treatment in an office setting. The treated area may include plaques on one or more body sites; the code level is based on the total area treated, not the number of plaques or body regions.

Select 96921 when the session’s total treated area is 250–500 square centimeters. Document the psoriasis diagnosis, sites treated, area measurement, and treatment performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this area-based service. CMS does not pay an assistant at surgery; 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 96921 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

$130.79 to $202.40

$130.79$166.59$202.40
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

96921 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$132.73$44.18
Alaska$169.68$61.90
Arizona$144.14$46.07
Arkansas$130.79$43.85
Atlanta, GA$150.20$47.37
Austin, TX$154.67$47.60
Bakersfield, CA$159.26$48.34
Baltimore area, MD$157.31$48.72
Beaumont, TX$137.32$45.22
Brazoria, TX$146.85$46.56

96921 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.

$130.79

$180.75

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

View every state and territory as a table
96921 office rate range by state
State / territoryOffice rate rangeLocalities
AK$169.681
AL$132.731
AR$130.791
AZ$144.141
CA$159.10–$202.4029
CO$155.531
CT$157.861
DC$170.571
DE$146.571
FL$143.48–$154.823
GA$135.56–$150.202
GU$163.471
HI$163.471
IA$137.201
ID$137.881
IL$138.52–$152.374
IN$138.721
KS$136.051
KY$134.841
LA$134.43–$141.232
MA$154.38–$171.772
MD$149.56–$170.573
ME$138.08–$146.422
MI$137.94–$144.782
MN$150.431
MO$131.75–$142.343
MS$131.321
MT$147.961
NC$139.631
ND$147.171
NE$138.111
NH$152.611
NJ$160.06–$168.672
NM$138.501
NV$147.861
NY$141.71–$173.155
OH$137.781
OK$135.121
OR$147.10–$161.112
PA$138.28–$153.562
PR$149.241
RI$152.251
SC$138.861
SD$147.081
TN$136.681
TX$137.32–$154.678
UT$140.801
VA$145.58–$170.572
VI$149.241
VT$146.131
WA$154.24–$175.802
WI$142.121
WV$133.181
WY$147.621

How the 96921 rate is calculated

Each of 96921’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 · 96921

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.88

0.88 RVUs× 1.000 GPCI

Practice expense3.51

3.51 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

4.4300

Conversion factor

$33.4009

Medicare rate

$147.97

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

Payment rules and modifiers for 96921

The CMS indicators that decide how 96921 is paid alongside other services.

CMS payment indicators · 96921

Excimer laser, 250–500 square centimeters

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

96921 without 51 · national office

$147.97

Excimer laser, 250–500 square centimeters

96921-51 · Second procedure: 50%

$73.99

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

96921 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 96921

    Excimer laser, 250–500 square centimeters0.88 wRVU

    $147.97

  • 96920

    Excimer laser, under 250 sq cm0.81 wRVU

    $137.95−$10.02

  • 96922

    Excimer laser, more than 500 sq cm1.12 wRVU

    $176.02+$28.05

  • 96910

    Phototherapy, tar or petrolatum with UVB0 wRVU

    $114.90−$33.07

  • 96912

    PUVA therapy, psoralen plus UVA0 wRVU

    $97.20−$50.77

How to choose

96920Excimer laserUnder 250 sq cm
Use 96920 when the total area treated with excimer laser is below 250 square centimeters; 96921 begins at 250.
96922Excimer laserMore than 500 sq cm
Use 96922 when the total excimer-laser treatment area exceeds 500 square centimeters; 96921 covers the range through 500.
96910PhototherapyTar or petrolatum with UVB
96910 describes tar- or petrolatum-assisted UVB phototherapy, not targeted excimer laser treatment.
96912PUVA therapyPsoralen plus UVA
96912 is for PUVA photochemotherapy; 96921 is the excimer laser treatment level selected by treated area.

96921 billing questions

How is 96921 distinguished from 96920 and 96922?

Choose the level by the total skin area treated during the session: 96921 covers 250–500 square centimeters. The neighboring codes cover smaller and larger treatment areas.

Should separate plaques be reported as separate units?

Select the code using the total treated area across the session, rather than counting plaques or body sites as units. Document how the treated area was determined.

Can modifier 50 be used when plaques are treated on both sides of the body?

No. The code is selected by total treated area, and CMS identifies bilateral adjustment as inappropriate for this service.

What same-day care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care. CMS applies the multiple procedure reduction when other procedures are performed in the same session.

What documentation supports reporting 96921?

Record the psoriasis diagnosis, body sites treated, total area treated in square centimeters, and the excimer laser treatment 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

Show the CMS file lines behind this rate
RVUs for 96921PPRRVU2026_Oct_nonQPP.csv, line 12,831 (RVU26D)

Open CMS sourceHow we calculate rates

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