Billing code 96571: Endoscopic photodynamic therapyMedicare rate & RVUs
Reports each additional 15 minutes of endoscopic photodynamic therapy beyond the initial service, when treatment uses light to ablate abnormal tissue.
Medicare pays $26.72 for 96571 nationally in the office and $23.38 in a hospital or facility. Local office rates run $24.97–$35.59.
Medicare rate · 96571
Endoscopic photodynamic therapy
- Work RVUs
- 0.55
- Total RVUs
- 0.80
- Global days
- ZZZ
National rate · 2026
$26.72
Office setting, before claim adjustments.
See every locality for 96571 →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.
On this page 10 sections
What 96571 covers
This add-on captures additional time for photodynamic therapy delivered through an endoscope, using light to activate a photosensitizing drug and ablate abnormal tissue. Physicians and other qualified health care professionals may perform the treatment in an endoscopy suite, hospital outpatient department, or ambulatory surgery center. Examples include endoscopic treatment of Barrett esophagus and selected endobronchial lesions.
Report 96571 only with 96570, which accounts for the initial 30 minutes; 96571 represents each additional 15 minutes. Documentation should identify the endoscopic PDT service and support the additional treatment time. CMS classifies 96571 as an add-on code and places its payment within the primary procedure's global period. It is not a stand-alone report for the endoscopic treatment.
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 96571 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
$24.97 to $35.59
109 of 109 payment localities
96571 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$24.97
$35.59
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $35.59 | 1 |
| AL | $25.16 | 1 |
| AR | $24.97 | 1 |
| AZ | $26.27 | 1 |
| CA | $26.90–$30.92 | 29 |
| CO | $27.00 | 1 |
| CT | $27.95 | 1 |
| DC | $29.09 | 1 |
| DE | $26.56 | 1 |
| FL | $27.27–$29.55 | 3 |
| GA | $26.32–$27.22 | 2 |
| GU | $26.93 | 1 |
| HI | $26.93 | 1 |
| IA | $25.15 | 1 |
| ID | $25.31 | 1 |
| IL | $27.08–$29.05 | 4 |
| IN | $25.37 | 1 |
| KS | $25.25 | 1 |
| KY | $25.84 | 1 |
| LA | $25.88–$26.55 | 2 |
| MA | $27.03–$28.59 | 2 |
| MD | $26.85–$29.09 | 3 |
| ME | $25.56–$26.04 | 2 |
| MI | $26.35–$27.63 | 2 |
| MN | $25.74 | 1 |
| MO | $25.76–$26.40 | 3 |
| MS | $25.36 | 1 |
| MT | $26.72 | 1 |
| NC | $25.67 | 1 |
| ND | $25.73 | 1 |
| NE | $25.17 | 1 |
| NH | $26.79 | 1 |
| NJ | $28.23–$29.06 | 2 |
| NM | $26.50 | 1 |
| NV | $26.45 | 1 |
| NY | $25.89–$30.59 | 5 |
| OH | $26.15 | 1 |
| OK | $25.63 | 1 |
| OR | $26.20–$27.33 | 2 |
| PA | $26.08–$27.65 | 2 |
| PR | $26.77 | 1 |
| RI | $27.11 | 1 |
| SC | $25.96 | 1 |
| SD | $25.61 | 1 |
| TN | $25.34 | 1 |
| TX | $26.00–$27.45 | 8 |
| UT | $26.15 | 1 |
| VA | $26.12–$29.09 | 2 |
| VI | $26.77 | 1 |
| VT | $25.83 | 1 |
| WA | $26.91–$28.85 | 2 |
| WI | $25.28 | 1 |
| WV | $26.57 | 1 |
| WY | $26.29 | 1 |
How the 96571 rate is calculated
Each of 96571’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 · 96571
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense0.20
0.20 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
0.8000
Conversion factor
$33.4009
Medicare rate
$26.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96571
The CMS indicators that decide how 96571 is paid alongside other services.
CMS payment indicators · 96571
Endoscopic photodynamic therapy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
96571 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 96570Photodynamic therapy
- 96570 covers the initial 30 minutes of endoscopic PDT. 96571 is reported for each additional 15 minutes and requires 96570.
- 96567Photodynamic therapy
- 96567 concerns external-light PDT for premalignant lesions of the skin and adjacent mucosa; 96571 is additional time for endoscopic PDT.
- 96573Photodynamic therapy
- 96573 describes the initial external-light PDT service for premalignant lesions. Choose 96571 only for additional time in an endoscopic PDT service.
96571 billing questions
When should 96571 be reported instead of 96570?
Use 96570 for the initial 30 minutes of endoscopic photodynamic therapy. Report 96571 for each additional 15 minutes beyond that initial service.
Can 96571 be billed by itself?
No. It is an add-on code and must be reported with the primary endoscopic photodynamic therapy service, 96570.
What documentation supports units of 96571?
Document the endoscopic PDT service and the additional treatment time beyond the initial period. Each unit represents an additional 15 minutes.
Is 96571 interchangeable with the skin PDT codes?
No. 96571 is for additional time in endoscopic PDT. Codes 96567 and 96573 describe external-light PDT for premalignant lesions of the skin and adjacent mucosa.
Does 96571 have its own global period?
CMS identifies it as an add-on paid within the primary procedure's global period; report it with 96570 rather than as an independent service.
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
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