$112.68–$121.36
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.
On this page
CMS RVU26D · Effective 2026-10-01
96931 Confocal microscopy Medicare reimbursement rates in Maine
Reports reflectance confocal microscopy image acquisition and interpretation for the first skin lesion evaluated during the service. Compare 96931 office and facility rates across CMS payment localities in Maine.
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.
What does Medicare pay for 96931 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$153.18–$162.94
2 of 2 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Dermatology imaging
About 96931: Reflectance confocal microscopy, first lesion
Reports reflectance confocal microscopy image acquisition and interpretation for the first skin lesion evaluated during the service.
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.
CMS billing rules for 96931
- Professional and technical components
- Global-test-only code: separate codes describe the professional and technical components.
Where the value comes from
- Work RVU0.78 · 16%
- Practice expense (office) RVU4.11 · 83%
- Malpractice RVU0.04 · 1%
340
Medicare services in 2024 · #3886 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.
96931 compared with similar codes
Office rates for Maine, from the same CMS release.
$40.50–$41.58
Use 96933 when only interpretation and reporting are performed for the first lesion. Use 96931 when the service also includes image acquisition.
$108.00–$114.39
96934 is for both RCM acquisition and interpretation for an additional lesion; 96931 covers the first lesion.
96904
No office rateWhole body photography
96904 describes whole-body photography, not reflectance confocal microscopy image acquisition and interpretation focused on a lesion.
Compare 96931 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$153.18
Facility
Unavailable
Southern Maine →
Office / nonfacility
$162.94
Facility
Unavailable
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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 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.
12,83096920,,Excimer lsr psriasis<250sqcm,A,,0.81,3.28,,0.38,,0.04,4.13,1.23,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,83196921,,Excimer lsr psriasis 250-500,A,,0.88,3.51,,0.48,,0.04,4.43,1.40,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,83296922,,Excimer lsr psriasis>500sqcm,A,,1.12,4.10,,1.08,,0.05,5.27,2.25,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,83396931,,Rcm img acquisj&i&r 1st les,A,,0.78,4.11,,4.11,NA,0.04,4.93,4.93,4,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,83496932,,Rcm img acquisj only 1st les,A,,0.00,3.66,,3.66,NA,0.01,3.67,3.67,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,83596933,,Rcm i&r only 1st lesion,A,,0.78,0.45,,0.45,NA,0.03,1.26,1.26,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,83696934,,Rcm img acquisj&i&r ea addl,A,,0.74,2.69,,2.69,NA,0.03,3.46,3.46,4,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00