Billing code 96936: RCM interpretationMedicare rate & RVUs in Ohio
Reports interpretation and written findings from reflectance confocal microscopy of each additional skin lesion after a primary RCM service.
Medicare pays $38.23 for 96936 in the office in Ohio (Ohio). 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 96936 covers
Reflectance confocal microscopy (RCM) uses noninvasive optical imaging to assess cellular detail in a skin lesion. Code 96936 represents the dermatologist’s interpretation and report for each lesion after the first; it does not include image acquisition. Dermatologists use RCM to evaluate selected lesions in vivo when microscopic assessment can inform lesion management, commonly in an office-based dermatology setting.
Report one unit for each additional lesion interpreted, only with an appropriate first-lesion RCM procedure. Documentation should identify the lesions examined and support a separate interpretation and report for each additional lesion. This add-on code is not submitted alone; CMS places its payment within the primary procedure’s global period. Code 96936 covers the professional interpretation and report only. Image acquisition is represented by the applicable separate code when performed, such as 96935 for additional-lesion acquisition without interpretation.
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.
96936 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $38.23 | Unavailable |
How the 96936 rate is calculated
Each of 96936’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 · 96936
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.74Practice expense 0.41Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96936
The CMS indicators that decide how 96936 is paid alongside other services.
CMS payment indicators · 96936
RCM interpretation
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 2 | Professional component only. |
96936 compared with similar codes
Compare codes
96936 vs 96933 vs 96935 vs 96934: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96933Confocal microscopy
- Use 96933 for interpretation and reporting of the first lesion. Use 96936 for each additional lesion interpreted and reported.
- 96935Confocal imaging
- Use 96935 for image acquisition only on an additional lesion. Use 96936 for interpretation and reporting only.
- 96934Skin imaging
- Code 96934 represents both image acquisition and interpretation for an additional lesion; 96936 represents interpretation and reporting only.
96936 billing questions
Can 96936 be reported by itself?
No. It is an add-on for interpretation and reporting of each additional lesion and must accompany a primary RCM procedure.
How does 96936 differ from 96933?
Both represent interpretation and reporting without image acquisition. Code 96933 is for the first lesion; 96936 is for each additional lesion.
Does 96936 include image acquisition?
No. It covers the professional interpretation and report only. For additional-lesion image acquisition without interpretation, 96935 is the corresponding family code.
How many units should be reported?
Report one unit for each additional lesion with its own interpretation and report. The record should identify each lesion and document the findings.
What does CMS payment treatment mean for this add-on?
CMS treats 96936 as payable only with a primary procedure and within that procedure’s global period. It is not a stand-alone 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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