FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

96567 in Beaumont

Office / nonfacility

$117.63

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Dermatology procedure

About 96567: External-light photodynamic therapy for skin lesions

Reports an external-light photodynamic treatment using a photosensitizing agent to destroy premalignant lesions of the skin or adjacent mucosa.

This service treats premalignant lesions, commonly actinic keratoses on sun-damaged skin such as the face or scalp, with a photosensitizing agent followed by external illumination. The treatment is typically furnished in a dermatology office, with clinical staff performing the service under physician supervision. The light activates the agent in the treated area to damage the targeted abnormal cells.

Report one unit for each treatment, rather than one unit per lesion. Documentation should identify the treated area, photosensitizing agent, light treatment, and physician supervision. Under the CMS rule for this code, Medicare billing is limited to performance under physician supervision as an incident-to service. When a physician or other qualified health care professional performs the photodynamic treatment, distinguish that service from this staff-performed code and consider 96573. Separate lesion debridement performed to prepare for photodynamic therapy may be reported with 96574 when supported by the documentation.

CMS billing rules for 96567

Professional and technical components
Incident-to service: billed only when performed under physician supervision.

Where the value comes from

  • Work RVU0.00 · 0%
  • Practice expense (office) RVU3.86 · 100%
  • Malpractice RVU0.01 · 0%

44.4K

Medicare services in 2024 · #826 by national volume

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.

96567 compared with similar codes

Office rates for Beaumont, from the same CMS release.

96573

Photodynamic therapy

Includes agent application

$199.30

Both describe external-light photodynamic treatment of premalignant lesions. 96567 is the incident-to service under physician supervision; 96573 is for treatment performed by a physician or other qualified health care professional.

96574

Lesion debridement

For photodynamic therapy

$245.83

96574 describes debridement that prepares premalignant lesions for photodynamic therapy, not the photosensitizer-and-light treatment itself.

17000

Premalignant lesion destruction

First lesion

$62.30

17000 describes destruction of a first premalignant skin lesion using a method other than photodynamic therapy. Use 96567 when the documented treatment uses a photosensitizing agent and external light.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 96567 is $136.70—$19.07 higher than the $117.63 rate in Beaumont. Both use the same code, release and participation basis.

96567 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $117.63

  2. Austin

    $136.70

    $19.07 higher than Beaumont

  3. Brazoria

    $128.03

    $10.40 higher than Beaumont

  4. Dallas

    $128.70

    $11.07 higher than Beaumont

  5. Fort Worth

    $127.41

    $9.78 higher than Beaumont

  6. Galveston

    $128.30

    $10.67 higher than Beaumont

  7. Houston

    $128.48

    $10.85 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 96567 ranges from $110.92 in Arkansas to $186.09 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 96567

    Office

    $122.65

    Facility

    Unavailable

    $5.02 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 96567

    Office

    $152.74

    Facility

    Unavailable

    $35.11 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96567

    Office

    $152.25

    Facility

    Unavailable

    $34.62 higher than Beaumont for the office setting.

  • Miami

    Florida · 96567

    Office

    $135.06

    Facility

    Unavailable

    $17.43 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 96567

    Office

    $130.34

    Facility

    Unavailable

    $12.71 higher than Beaumont for the office setting.

  • Manhattan

    New York · 96567

    Office

    $150.34

    Facility

    Unavailable

    $32.71 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 96567

    Office

    $137.49

    Facility

    Unavailable

    $19.86 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 96567

    Office

    $113.00

    Facility

    Unavailable

    $4.63 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 96567

    Office

    $110.92

    Facility

    Unavailable

    $6.71 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 96567

    Office

    $125.22

    Facility

    Unavailable

    $7.59 higher than Beaumont for the office setting.

  • Bakersfield

    California · 96567

    Office

    $141.51

    Facility

    Unavailable

    $23.88 higher than Beaumont for the office setting.

  • Chico

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • El Centro

    California · 96567

    Office

    $141.49

    Facility

    Unavailable

    $23.86 higher than Beaumont for the office setting.

  • Fresno

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Madera

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Merced

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Modesto

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Napa

    California · 96567

    Office

    $170.10

    Facility

    Unavailable

    $52.47 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96567

    Office

    $152.60

    Facility

    Unavailable

    $34.97 higher than Beaumont for the office setting.

  • Redding

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Rest Of California

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96567

    Office

    $141.59

    Facility

    Unavailable

    $23.96 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96567

    Office

    $150.12

    Facility

    Unavailable

    $32.49 higher than Beaumont for the office setting.

  • Salinas

    California · 96567

    Office

    $149.61

    Facility

    Unavailable

    $31.98 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96567

    Office

    $154.38

    Facility

    Unavailable

    $36.75 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96567

    Office

    $181.94

    Facility

    Unavailable

    $64.31 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 96567

    Office

    $181.93

    Facility

    Unavailable

    $64.30 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 96567

    Office

    $186.09

    Facility

    Unavailable

    $68.46 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 96567

    Office

    $186.05

    Facility

    Unavailable

    $68.42 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96567

    Office

    $147.03

    Facility

    Unavailable

    $29.40 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 96567

    Office

    $156.83

    Facility

    Unavailable

    $39.20 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 96567

    Office

    $150.51

    Facility

    Unavailable

    $32.88 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 96567

    Office

    $158.50

    Facility

    Unavailable

    $40.87 higher than Beaumont for the office setting.

  • Stockton

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Vallejo

    California · 96567

    Office

    $170.08

    Facility

    Unavailable

    $52.45 higher than Beaumont for the office setting.

  • Visalia

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Yuba City

    California · 96567

    Office

    $141.48

    Facility

    Unavailable

    $23.85 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 96567

    Office

    $137.44

    Facility

    Unavailable

    $19.81 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 96567

    Office

    $139.26

    Facility

    Unavailable

    $21.63 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 96567

    Office

    $127.68

    Facility

    Unavailable

    $10.05 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 96567

    Office

    $131.21

    Facility

    Unavailable

    $13.58 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 96567

    Office

    $123.76

    Facility

    Unavailable

    $6.13 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 96567

    Office

    $131.39

    Facility

    Unavailable

    $13.76 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 96567

    Office

    $115.40

    Facility

    Unavailable

    $2.23 lower than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 96567

    Office

    $146.78

    Facility

    Unavailable

    $29.15 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 96567

    Office

    $118.10

    Facility

    Unavailable

    $0.47 higher than Beaumont for the office setting.

  • Idaho

    Idaho · 96567

    Office

    $118.77

    Facility

    Unavailable

    $1.14 higher than Beaumont for the office setting.

  • East St. Louis

    Illinois · 96567

    Office

    $119.29

    Facility

    Unavailable

    $1.66 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 96567

    Office

    $118.23

    Facility

    Unavailable

    $0.60 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 96567

    Office

    $133.00

    Facility

    Unavailable

    $15.37 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 96567

    Office

    $119.68

    Facility

    Unavailable

    $2.05 higher than Beaumont for the office setting.

  • Kansas

    Kansas · 96567

    Office

    $116.72

    Facility

    Unavailable

    $0.91 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 96567

    Office

    $114.92

    Facility

    Unavailable

    $2.71 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 96567

    Office

    $121.70

    Facility

    Unavailable

    $4.07 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 96567

    Office

    $114.42

    Facility

    Unavailable

    $3.21 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 96567

    Office

    $154.24

    Facility

    Unavailable

    $36.61 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96567

    Office

    $136.03

    Facility

    Unavailable

    $18.40 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96567

    Office

    $138.75

    Facility

    Unavailable

    $21.12 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 96567

    Office

    $130.78

    Facility

    Unavailable

    $13.15 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 96567

    Office

    $118.82

    Facility

    Unavailable

    $1.19 higher than Beaumont for the office setting.

  • Southern Maine

    Maine · 96567

    Office

    $127.98

    Facility

    Unavailable

    $10.35 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 96567

    Office

    $124.98

    Facility

    Unavailable

    $7.35 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 96567

    Office

    $118.09

    Facility

    Unavailable

    $0.46 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 96567

    Office

    $132.77

    Facility

    Unavailable

    $15.14 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 96567

    Office

    $121.39

    Facility

    Unavailable

    $3.76 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 96567

    Office

    $123.07

    Facility

    Unavailable

    $5.44 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 96567

    Office

    $111.46

    Facility

    Unavailable

    $6.17 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 96567

    Office

    $111.25

    Facility

    Unavailable

    $6.38 lower than Beaumont for the office setting.

  • Montana**

    Montana · 96567

    Office

    $129.26

    Facility

    Unavailable

    $11.63 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 96567

    Office

    $120.50

    Facility

    Unavailable

    $2.87 higher than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 96567

    Office

    $129.06

    Facility

    Unavailable

    $11.43 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 96567

    Office

    $119.13

    Facility

    Unavailable

    $1.50 higher than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 96567

    Office

    $134.51

    Facility

    Unavailable

    $16.88 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 96567

    Office

    $149.91

    Facility

    Unavailable

    $32.28 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 96567

    Office

    $141.16

    Facility

    Unavailable

    $23.53 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 96567

    Office

    $118.63

    Facility

    Unavailable

    $1.00 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 96567

    Office

    $129.33

    Facility

    Unavailable

    $11.70 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96567

    Office

    $153.92

    Facility

    Unavailable

    $36.29 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96567

    Office

    $141.58

    Facility

    Unavailable

    $23.95 higher than Beaumont for the office setting.

  • Queens

    New York · 96567

    Office

    $152.87

    Facility

    Unavailable

    $35.24 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 96567

    Office

    $122.72

    Facility

    Unavailable

    $5.09 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 96567

    Office

    $118.05

    Facility

    Unavailable

    $0.42 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 96567

    Office

    $115.39

    Facility

    Unavailable

    $2.24 lower than Beaumont for the office setting.

  • Portland

    Oregon · 96567

    Office

    $143.49

    Facility

    Unavailable

    $25.86 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 96567

    Office

    $128.65

    Facility

    Unavailable

    $11.02 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96567

    Office

    $134.61

    Facility

    Unavailable

    $16.98 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96567

    Office

    $118.67

    Facility

    Unavailable

    $1.04 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 96567

    Office

    $130.67

    Facility

    Unavailable

    $13.04 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 96567

    Office

    $133.48

    Facility

    Unavailable

    $15.85 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 96567

    Office

    $119.41

    Facility

    Unavailable

    $1.78 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 96567

    Office

    $129.04

    Facility

    Unavailable

    $11.41 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 96567

    Office

    $117.37

    Facility

    Unavailable

    $0.26 lower than Beaumont for the office setting.

  • Utah

    Utah · 96567

    Office

    $121.49

    Facility

    Unavailable

    $3.86 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 96567

    Office

    $126.97

    Facility

    Unavailable

    $9.34 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96567

    Office

    $130.67

    Facility

    Unavailable

    $13.04 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 96567

    Office

    $127.81

    Facility

    Unavailable

    $10.18 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 96567

    Office

    $136.01

    Facility

    Unavailable

    $18.38 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 96567

    Office

    $158.47

    Facility

    Unavailable

    $40.84 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 96567

    Office

    $123.62

    Facility

    Unavailable

    $5.99 higher than Beaumont for the office setting.

  • West Virginia

    West Virginia · 96567

    Office

    $112.52

    Facility

    Unavailable

    $5.11 lower than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 96567

    Office

    $129.17

    Facility

    Unavailable

    $11.54 higher than Beaumont for the office setting.

See how rates vary across the country

96567 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$110.92

$163.79

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$137.491
AL$113.001
AR$110.921
AZ$125.221
CA$141.48–$186.0929
CO$137.441
CT$139.261
DC$152.251
DE$127.681
FL$123.76–$135.063
GA$115.40–$131.392
GU$146.781
HI$146.781
IA$118.101
ID$118.771
IL$118.23–$133.004
IN$119.681
KS$116.721
KY$114.921
LA$114.42–$121.702
MA$136.03–$154.242
MD$130.78–$152.253
ME$118.82–$127.982
MI$118.09–$124.982
MN$132.771
MO$111.46–$123.073
MS$111.251
MT$129.261
NC$120.501
ND$129.061
NE$119.131
NH$134.511
NJ$141.16–$149.912
NM$118.631
NV$129.331
NY$122.72–$153.925
OH$118.051
OK$115.391
OR$128.65–$143.492
PA$118.67–$134.612
PR$130.671
RI$133.481
SC$119.411
SD$129.041
TN$117.371
TX$117.63–$136.708
UT$121.491
VA$126.97–$152.252
VI$130.671
VT$127.811
WA$136.01–$158.472
WI$123.621
WV$112.521
WY$129.171

Explore 96567 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96567 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$129.39

$117.63 × 110% = $129.39

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96567 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

12,819

Code
96567
Physician work
0.00
Practice expense
3.86
Malpractice
0.01

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 96567 in Beaumont
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense3.86× 0.9103.5126
Malpractice0.01× 0.9290.0093
Total RVUs3.5219
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$117.63

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 96567 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work01
Practice expense3.860.91
Malpractice0.010.929

(0 × 1 + 3.86 × 0.91 + 0.01 × 0.929) × $33.4009 = $117.63

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

96567 · Office / nonfacility

$117.63

Effective 2026-10-01

The base rate is $2.24 higher than on 2025-10-01, moving from $115.39 to $117.63 (1.9%).

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

    $115.39changed to$117.63

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.94 changed to 3.86
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $115.39

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$117.63Not available in this settingRVU26D
2026-07-01$117.63Not available in this settingRVU26C
2026-04-01$117.63Not available in this settingRVU26B
2026-01-01$117.63Not available in this settingRVU26A
2025-10-01$115.39Not available in this settingRVU25D
2025-07-01$115.39Not available in this settingRVU25C
2025-04-01$115.39Not available in this settingRVU25B
2025-01-01$115.39Not available in this settingRVU25A

96567 billing questions

Is 96567 reported for each lesion?

No. Report one unit for each photodynamic treatment, not for each individual actinic keratosis or other treated lesion.

How does 96567 differ from 96573?

96567 is the incident-to service performed under physician supervision. Use 96573 when the physician or other qualified health care professional performs the external-light photodynamic treatment.

Does 96567 require physician supervision?

Yes. CMS identifies this as an incident-to service and permits billing only when it is performed under physician supervision.

Can debridement be reported with the photodynamic treatment?

When a physician or other qualified health care professional separately performs debridement to prepare premalignant lesions for photodynamic therapy, 96574 may describe that service. Document the debridement and its relationship to the treatment.

When might a destruction code be used instead?

Codes such as 17000 describe lesion destruction by methods other than photodynamic therapy. Choose the code that matches the procedure actually performed, not simply the diagnosis.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 96567PPRRVU2026_Oct_nonQPP.csv, line 12,819 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet