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See a sample rate comparisonCPT 96935 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Reflectance Confocal Microscop, Reflectance Confocal Microscopy (Rcm) For Cellularand Sub-Cellular Imaging Of Skin Image Acquisiti On Only Each Additional Lesion (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Dermatological Procedures |
| Common Place of Service | 11 - Office |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $76.15 national non-facility rate (2026) · View Medicare rates for 96935 |
| Medicaid Fee Schedule | $59.015 median of the 8 states in the free preview · View Medicaid rates for 96935 |
National average reimbursement for CPT 96935 by major payers:
$80.38
$64.14
$75.77
$132.09
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CPT 96935
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$454.64Published rateLara Segalite
Advocate Health And Hospitals Corporation
$123.93Published rateLeah Ustas
Advocate Health And Hospitals Corporation
$101.62Published rateCharles Marcuccilli
Pediatric Faculty Foundation In
$82.05Published rateOfelia Ionescu
Ofelia Martha Ionescu Ltd
$40.13Published rate
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See a sample payer proposalCPT 96935 vs. Other Special Dermatological Procedures Codes
The CPT 96935 code is part of the Medicine Services and Procedures services used for Special Dermatological Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 96935 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 96931-CPT | Moderate | Reflectance Confocal Microscop, Reflectance Confocal Microscopy (Rcm) For Cellularand Sub-Cellular Imaging Of Skin Image Acquisiti On And Interpretation And Report First Lesion |
| 96932-CPT | Low | Reflectance Confocal Microscop, Reflectance Confocal Microscopy (Rcm) For Cellularand Sub-Cellular Imaging Of Skin Image Acquisiti On Only First Lesion |
| 96933-CPT | Low | Rcm Celulr Subcelulr Img Skn, Reflectance Confocal Microscopy Rcm For Cellular And Sub Cellular Imaging Of Skin Interpretation And Report Only First Lesion |
| 96935-CPT | Low | Reflectance Confocal Microscop, Reflectance Confocal Microscopy (Rcm) For Cellularand Sub-Cellular Imaging Of Skin Image Acquisiti On Only Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96935. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96935 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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