How much does Medicare pay for CPT 96910?

Medicare allowed an average of $122.72 per service and paid $95.97 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $234.57, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96910?

Therapy procedure using ultraviolet radiation with tar or petroleum jelly application. It was billed 176,479 times to 12,879 Medicare beneficiaries by 552 providers in 2024.

Does 96910 pay differently in an office than a hospital?

Yes. The allowed amount averaged $122.73 in an office setting and $101.94 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 96910 most?

Dermatology, with 150,529 services from 427 clinicians. Next are Nurse Practitioner, Physician Assistant, Micrographic Dermatologic Surgery.

CPT 96910

Therapy procedure using ultraviolet radiation with tar or petroleum jelly application

$122.72Medicare-allowed amount per service, averaged across 176,479 services

Providers submitted

$234.57

Asking price, not received

Medicare allowed

$122.72

The fee schedule figure

Medicare paid

$95.97

Balance is patient coinsurance

Providers submitted an average of $234.57 for this code and Medicare allowed $122.72 — 1.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $95.97 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $122.73
Hospital / facility: $101.94

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 176,459 services were billed in an office setting and 20 in a facility.

Services: 176,479
Beneficiaries: 12,879
Providers billing it: 552
Total allowed: $21,657,503

What Medicare pays for CPT 96910

Across 176,479 services billed by 552 providers to 12,879 beneficiaries, Medicare allowed an average of $122.72 per service. That is 13.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 96910

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	150,529	10,100	$125.56	427
Nurse Practitioner	14,847	1,214	$107.51	43
Physician Assistant	9,790	1,284	$101.60	68
Micrographic Dermatologic Surgery	660	68	$139.71	4
General Practice	255	70	$114.77	3
Pathology	136	16	$106.19	1
Vascular Surgery	113	23	$116.30	1
Family Practice	77	38	$113.70	2
Podiatry	57	55	$120.17	2
Plastic and Reconstructive Surgery	15	11	$115.61	1

96910 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	52,700	$137.40	$89.58	92
Florida	27,691	$109.34	$86.70	58
New York	12,021	$130.46	$89.53	56
Maryland	11,048	$125.97	$89.22	33
Massachusetts	7,841	$128.44	$90.19	23
Texas	7,523	$108.79	$89.76	44
Illinois	6,977	$114.51	$88.99	25
New Jersey	6,557	$132.35	$88.63	32
South Carolina	3,714	$107.69	$89.72	3
Pennsylvania	3,682	$119.25	$90.56	14
Delaware	3,331	$116.18	$91.07	10
North Carolina	2,595	$107.88	$88.63	5
Washington	2,421	$116.29	$84.99	9
Michigan	2,397	$109.90	$90.92	12
Wisconsin	2,253	$111.49	$88.15	13
Minnesota	2,121	$115.20	$88.84	10
Arizona	2,042	$114.70	$85.44	8
Ohio	1,659	$105.11	$90.59	6
Indiana	1,612	$98.99	$90.27	10
Iowa	1,427	$105.46	$86.83	6
Guam	1,413	$123.30	$90.71	1
Colorado	1,399	$122.92	$89.62	9
Tennessee	1,386	$97.55	$84.20	9
Virginia	1,332	$119.45	$89.86	6
Oregon	1,230	$115.39	$86.89	10
Missouri	1,146	$110.69	$88.57	11
Rhode Island	1,125	$120.67	$90.59	1
Connecticut	986	$118.46	$88.02	3
Idaho	857	$103.67	$87.39	6
Alabama	665	$98.09	$89.70	2
Louisiana	649	$97.37	$87.60	10
New Mexico	629	$102.76	$88.61	3
District of Columbia	460	$119.02	$90.27	1
Hawaii	408	$123.10	$78.97	1
Kentucky	360	$108.46	$89.84	1
Mississippi	317	$87.77	$75.97	3
Vermont	230	$116.61	$89.83	3
Maine	172	$104.26	$77.24	1
Alaska	67	$114.24	$91.14	1
Georgia	36	$116.67	$90.16	1

Related codes

96900Application of ultraviolet light to skin$24.96
96920Treatment of inflammatory skin disease$159.83
96921Treatment of inflammatory skin disease$181.15
96922Treatment of inflammatory skin disease$249.51
96904Photograph of entire body$71.03

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.