$50.99
96570 covers the initial 30 minutes of endoscopic PDT. 96571 is reported for each additional 15 minutes and requires 96570.
On this page
CMS RVU26D · Effective 2026-10-01
96571 Endoscopic photodynamic therapy Medicare reimbursement rates in Vermont
Reports each additional 15 minutes of endoscopic photodynamic therapy beyond the initial service, when treatment uses light to ablate abnormal tissue. Compare 96571 office and facility rates across CMS payment localities in Vermont.
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 96571 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$25.83
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$22.52
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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.
Photodynamic therapy
About 96571: Additional endoscopic photodynamic therapy time
Reports each additional 15 minutes of endoscopic photodynamic therapy beyond the initial service, when treatment uses light to ablate abnormal tissue.
This add-on captures additional time for photodynamic therapy delivered through an endoscope, using light to activate a photosensitizing drug and ablate abnormal tissue. Physicians and other qualified health care professionals may perform the treatment in an endoscopy suite, hospital outpatient department, or ambulatory surgery center. Examples include endoscopic treatment of Barrett esophagus and selected endobronchial lesions.
Report 96571 only with 96570, which accounts for the initial 30 minutes; 96571 represents each additional 15 minutes. Documentation should identify the endoscopic PDT service and support the additional treatment time. CMS classifies 96571 as an add-on code and places its payment within the primary procedure's global period. It is not a stand-alone report for the endoscopic treatment.
CMS billing rules for 96571
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.55 · 69%
- Practice expense (office) RVU0.20 · 25%
- Malpractice RVU0.05 · 6%
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.
96571 compared with similar codes
Office rates for Vermont, from the same CMS release.
$127.81
96567 concerns external-light PDT for premalignant lesions of the skin and adjacent mucosa; 96571 is additional time for endoscopic PDT.
$215.10
96573 describes the initial external-light PDT service for premalignant lesions. Choose 96571 only for additional time in an endoscopic PDT service.
Compare 96571 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
$25.83
Facility
$22.52
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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 96571 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
12,821
- Code
- 96571
- Physician work
- 0.55
- Practice expense
- 0.20
- Malpractice
- 0.05
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.55 | × 1.000 | 0.5500 |
| Practice expense | 0.20 | × 0.990 | 0.1980 |
| Malpractice | 0.05 | × 0.506 | 0.0253 |
| Total RVUs | 0.7733 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$25.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.55 | 1 |
| Practice expense | 0.2 | 0.99 |
| Malpractice | 0.05 | 0.506 |
(0.55 × 1 + 0.2 × 0.99 + 0.05 × 0.506) × $33.4009 = $25.83
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.55 | 1 |
| Practice expense | 0.1 | 0.99 |
| Malpractice | 0.05 | 0.506 |
(0.55 × 1 + 0.1 × 0.99 + 0.05 × 0.506) × $33.4009 = $22.52
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.
96571 billing questions
When should 96571 be reported instead of 96570?
Use 96570 for the initial 30 minutes of endoscopic photodynamic therapy. Report 96571 for each additional 15 minutes beyond that initial service.
Can 96571 be billed by itself?
No. It is an add-on code and must be reported with the primary endoscopic photodynamic therapy service, 96570.
What documentation supports units of 96571?
Document the endoscopic PDT service and the additional treatment time beyond the initial period. Each unit represents an additional 15 minutes.
Is 96571 interchangeable with the skin PDT codes?
No. 96571 is for additional time in endoscopic PDT. Codes 96567 and 96573 describe external-light PDT for premalignant lesions of the skin and adjacent mucosa.
Does 96571 have its own global period?
CMS identifies it as an add-on paid within the primary procedure's global period; report it with 96570 rather than as an independent 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.
12,81896549,,Unlisted chemotherapy px,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81996567,,Pdt dstr prmlg les skn,A,,0.00,3.86,,3.86,NA,0.01,3.87,3.87,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,82096570,,Photodynmc tx 30 min add-on,A,,1.10,0.39,,0.20,,0.08,1.57,1.38,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,82196571,,Photodynamic tx addl 15 min,A,,0.55,0.20,,0.10,,0.05,0.80,0.70,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,82296573,,Pdt dstr prmlg les phys/qhp,A,,0.47,6.02,,6.02,NA,0.02,6.51,6.51,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,82396574,,Dbrdmt prmlg les w/pdt,A,,0.98,6.97,,6.97,NA,0.04,7.99,7.99,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,82496900,,Actinotherapy uv light,A,,0.00,0.70,,0.70,NA,0.01,0.71,0.71,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817