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See a sample rate comparisonCPT 96936 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 Interpretation And Report 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 19 - Off Campus Outpatient Hospital |
| Complexity Level | Low |
| Medicare Fee Schedule | $39.41 national non-facility rate (2026) · View Medicare rates for 96936 |
| Medicaid Fee Schedule | $32.425 median of the 8 states in the free preview · View Medicaid rates for 96936 |
National average reimbursement for CPT 96936 by major payers:
$59.07
$56.33
$51.48
$81.86
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CPT 96936
5 of 25 sample ratesHigher to lower in this preview
Ewa Bieber
$108.08Published rateSigita Plioplys
$88.80Published rateLance Holemon
$80.62Published rateSteven Sharp
Loyola University Medical Center
$69.80Published rateThomas Herrmann
Hoopeston Community Memorial Hospital
$39.72Published rate
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See a sample payer proposalCPT 96936 vs. Other Special Dermatological Procedures Codes
The CPT 96936 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 96936 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 |
|---|---|---|
| 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) |
| 96936-CPT | Low | Reflectance Confocal Microscop, Reflectance Confocal Microscopy (Rcm) For Cellularand Sub-Cellular Imaging Of Skin Interpretation And Report Only Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 96999-CPT | Moderate | Unlisted Special Dermatological Svc Or Proc, Unlisted Special Dermatological Service Or Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96936. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96936 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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