Billing code 96931: Confocal microscopyMedicare rate & RVUs in Alaska
Reports reflectance confocal microscopy image acquisition and interpretation for the first skin lesion evaluated during the service.
Medicare pays $186.02 for 96931 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 96931 covers
Reflectance confocal microscopy (RCM) uses noninvasive optical imaging to examine skin structures at a cellular level. Dermatology practices may use it to evaluate a suspicious lesion, such as when assessing features that can help distinguish benign from malignant change. The service produces images of the lesion without removing tissue for a conventional biopsy. A dermatologist or other qualified clinician interprets the images and documents the findings.
Report 96931 for the first lesion when the service includes both image acquisition and interpretation with a report. Documentation should identify the lesion examined, support the clinical reason for imaging, and include the acquired images and interpretation. This is the global-test code: when acquisition and interpretation are performed and reported separately, use the corresponding component codes rather than reporting 96931 for the same work. For additional lesions, select the applicable additional-lesion code based on whether both components or only one component was performed.
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.
96931 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $186.02 | Unavailable |
How the 96931 rate is calculated
Each of 96931’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 · 96931
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.78Practice expense 4.11Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96931
The CMS indicators that decide how 96931 is paid alongside other services.
CMS payment indicators · 96931
Confocal microscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 4 | Global test only. |
96931 compared with similar codes
Compare codes
96931 vs 96932 vs 96933 vs 96934 vs 96904: national Medicare rates
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How to choose
- 96932Confocal skin imaging
- Use 96932 when only RCM image acquisition is performed for the first lesion. Use 96931 when acquisition and interpretation with a report are both performed.
- 96933Confocal microscopy
- Use 96933 when only interpretation and reporting are performed for the first lesion. Use 96931 when the service also includes image acquisition.
- 96934Skin imaging
- 96934 is for both RCM acquisition and interpretation for an additional lesion; 96931 covers the first lesion.
- 96904Whole body photography
- 96904 describes whole-body photography, not reflectance confocal microscopy image acquisition and interpretation focused on a lesion.
96931 billing questions
When should 96931 be reported instead of 96932 or 96933?
Use 96931 when both RCM image acquisition and interpretation with a report are performed for the first lesion. Codes 96932 and 96933 describe acquisition only and interpretation/report only, respectively, for that first lesion.
Can 96931 be reported with its component codes for the same lesion?
Do not report the global service together with separate component codes for the same work. Use the component codes when acquisition and interpretation are separately performed and reported.
How is an additional lesion reported?
Use the additional-lesion code that matches the work performed: 96934 for acquisition and interpretation, 96935 for acquisition only, or 96936 for interpretation and report only.
What documentation supports 96931?
Document the lesion examined, the reason for RCM, image acquisition, and the clinician’s interpretation and report. The record should make clear that both components were completed for the first lesion.
Does 96931 describe a skin biopsy?
No. It describes noninvasive reflectance confocal imaging and interpretation; tissue removal for histopathologic examination is a different 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
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