CPT 96934
Global ZZZ ActiveRcm img acquisj&i&r ea addl
CPT 96934 Billing & Documentation Guide
CPT code 96934 (Rcm img acquisj&i&r ea addl) is classified under Dermatology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.74, a non-facility practice expense RVU of 2.69, and a malpractice RVU of 0.03, a total non-facility RVU of 3.46 and facility RVU of 3.46. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $119.85, though rates vary from $102.41 to $157.53 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 96934, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 96934 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 96934 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 96934
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.74 | 0.74 |
| Practice Expense RVU | 2.69 | 2.69 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 3.46 | 3.46 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 96934
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $132.46 | $132.46 | $124.15 - $157.53 | 29 |
| Florida | $116.81 | $116.81 | $112.12 - $120.78 | 3 |
| Georgia | $111.67 | $111.67 | $106.06 - $117.28 | 2 |
| Illinois | $113.54 | $113.54 | $108.31 - $118.94 | 4 |
| Michigan | $110.5 | $110.5 | $107.88 - $113.11 | 2 |
| North Carolina | $109.19 | $109.19 | $109.19 - $109.19 | 1 |
| New York | $127.49 | $127.49 | $110.78 - $134.99 | 5 |
| Ohio | $107.76 | $107.76 | $107.76 - $107.76 | 1 |
| Pennsylvania | $114.02 | $114.02 | $108.14 - $119.89 | 2 |
| Texas | $114.24 | $114.24 | $107.41 - $120.71 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 96934
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 96934 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0470T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0471T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76942 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76970 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76998 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0700T | Column 2 (secondary), bundled into primary | Yes | Mutually exclusive procedures |
| 0701T | Column 2 (secondary), bundled into primary | Yes | Mutually exclusive procedures |
Frequently Asked Questions, CPT 96934
What does CPT code 96934 mean? +
CPT code 96934 represents: Rcm img acquisj&i&r ea addl. It's in the Dermatology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 96934? +
The 2026 Medicare national average non-facility payment for CPT 96934 is $119.85. Rates range from $102.41 to $157.53 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 96934? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 96934? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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