CPT code 96921: Excimer laser2026 Medicare rate & RVUs in Utah
Targeted excimer laser treatment for psoriasis is reported when the total skin area treated in a session measures 250–500 square centimeters.
Medicare pays $140.80 for 96921 in the office in Utah (Utah). 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 96921 covers
This service uses an excimer laser to deliver targeted ultraviolet light to psoriasis plaques, limiting exposure of surrounding uninvolved skin. Dermatologists and other qualified practitioners typically perform the treatment in an office setting. The treated area may include plaques on one or more body sites; the code level is based on the total area treated, not the number of plaques or body regions.
Select 96921 when the session’s total treated area is 250–500 square centimeters. Document the psoriasis diagnosis, sites treated, area measurement, and treatment performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this area-based service. CMS does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
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.
96921 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $140.80 | $45.66 |
How the 96921 rate is calculated
Each of 96921’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 · 96921
RVUs × geographic indexes × conversion factor
Work0.88
0.88 RVUs× 1.000 GPCI
Practice expense3.51
3.51 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
4.4300
Conversion factor
$33.4009
Medicare rate
$147.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96921
The CMS indicators that decide how 96921 is paid alongside other services.
CMS payment indicators · 96921
Excimer laser
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
96921 without 51 · national office
$147.97
Excimer laser
96921-51 · Second procedure: 50%
$73.99
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
96921 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 96920Excimer laser
- Use 96920 when the total area treated with excimer laser is below 250 square centimeters; 96921 begins at 250.
- 96922Excimer laser
- Use 96922 when the total excimer-laser treatment area exceeds 500 square centimeters; 96921 covers the range through 500.
- 96910Phototherapy
- 96910 describes tar- or petrolatum-assisted UVB phototherapy, not targeted excimer laser treatment.
- 96912PUVA therapy
- 96912 is for PUVA photochemotherapy; 96921 is the excimer laser treatment level selected by treated area.
96921 billing questions
How is 96921 distinguished from 96920 and 96922?
Choose the level by the total skin area treated during the session: 96921 covers 250–500 square centimeters. The neighboring codes cover smaller and larger treatment areas.
Should separate plaques be reported as separate units?
Select the code using the total treated area across the session, rather than counting plaques or body sites as units. Document how the treated area was determined.
Can modifier 50 be used when plaques are treated on both sides of the body?
No. The code is selected by total treated area, and CMS identifies bilateral adjustment as inappropriate for this service.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care. CMS applies the multiple procedure reduction when other procedures are performed in the same session.
What documentation supports reporting 96921?
Record the psoriasis diagnosis, body sites treated, total area treated in square centimeters, and the excimer laser treatment performed.
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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