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CPT code 96365: IV drug infusion, initial, first hour2026 Medicare rate & RVUs in Delaware

Report the initial hour of a nonchemotherapy IV drug infusion lasting more than 15 minutes for treatment, prevention, or diagnosis.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4M Medicare services in 2024

In Delaware, Medicare pays $66.33 for 96365 in the office.

$66.33Office (non-facility)
Not available in this settingHospital or facility
−1.2%vs the national office rate ($67.14)

Check a contract rate as a % of Medicare · 96365 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 96365 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 96365 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 96365 covers

This code covers the initial hour of a therapeutic, preventive, or diagnostic IV drug infusion, such as an IV antibiotic or iron infusion lasting more than 15 minutes. Infusion nurses or other clinical staff commonly perform it in physician offices and infusion suites. IV access, routine flushes, tubing, and monitoring are included in the administration service. Staff document the drug, dose, route, and infusion start and stop times.

Select the initial administration code using the drug administration hierarchy, not simply the drug given first or the visit’s chief reason. Usually, one initial administration service is reported per encounter; a protocol requiring distinct IV sites may support another. Report 96366 when the same infusion reaches 91 minutes, 96367 for a subsequent infusion of a different drug, or 96368 for a concurrent infusion when each code’s requirements are met. Report the drug supply separately when applicable. Under the CMS incident-to rule, the service is billed only when performed under physician supervision. Most Medicare services for this code are billed in offices.

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.

How Delaware compares for 96365

Across 109 of 109 payment localities, the office rate for 96365 runs from $58.20 in Arkansas to $93.27 in San Benito County, CA. Delaware pays $66.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

96365 in Delaware vs other payment areas
  1. Delaware · this page$66.33
  2. Los Angeles, CA · California$77.73+$11.40
  3. Washington, DC area · District of Columbia$78.13+$11.80
  4. Miami, FL · Florida$71.59+$5.26
  5. Chicago, IL · Illinois$69.21+$2.88
  6. Manhattan, NY · New York$77.89+$11.56
  7. Alaska · Alaska$73.86+$7.53

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

96365 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$59.21—
ArkansasArkansas$58.20—
ArizonaArizona$65.12—
Bakersfield, CACalifornia$72.39—
Chico, CACalifornia$72.28—
El Centro, CACalifornia$72.29—
Fresno, CACalifornia$72.28—
Hanford, CACalifornia$72.28—

96365 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$58.20

$82.78

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
96365 office rate range by state
State / territoryOffice rate rangeLocalities
AK$73.861
AL$59.211
AR$58.201
AZ$65.121
CA$72.28–$93.2729
CO$70.691
CT$72.081
DC$78.131
DE$66.331
FL$65.22–$71.593
GA$61.04–$68.372
GU$74.631
HI$74.631
IA$61.331
ID$61.731
IL$62.77–$69.804
IN$62.161
KS$60.831
KY$60.501
LA$60.32–$63.852
MA$70.09–$78.682
MD$67.80–$78.133
ME$61.93–$66.112
MI$62.19–$65.992
MN$67.901
MO$58.99–$64.323
MS$58.621
MT$67.131
NC$62.711
ND$66.341
NE$61.781
NH$69.381
NJ$72.95–$77.072
NM$62.531
NV$66.971
NY$63.80–$79.845
OH$62.031
OK$60.551
OR$66.50–$73.432
PA$62.24–$69.932
PR$67.761
RI$69.061
SC$62.471
SD$66.251
TN$61.171
TX$61.75–$70.418
UT$63.471
VA$65.74–$78.132
VI$67.761
VT$65.891
WA$70.02–$80.592
WI$63.741
WV$60.011
WY$66.791

See 96365 in every payment locality

How the 96365 rate is calculated

Each of 96365’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 96365

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.21

0.21 RVUs× 1.000 GPCI

Practice expense1.76

1.76 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.0100

Conversion factor

$33.4009

Medicare rate

$67.14

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,779

Code
96365
Physician work
0.21
Practice expense
1.76
Malpractice
0.04

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 96365 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0050.2110
Practice expense1.76× 0.9881.7389
Malpractice0.04× 0.8990.0360
Total RVUs1.9859
Conversion factor× 33.4009

Office rate, Delaware$66.33

Office: (0.21 × 1.005 + 1.76 × 0.988 + 0.04 × 0.899) × $33.4009 = $66.33

Open 96365 in the RVU calculator

Payment rules and modifiers for 96365

The CMS indicators that decide how 96365 is paid alongside other services.

CMS payment indicators · 96365

IV drug infusion, initial, first hour

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical5Incident-to service.

Codes related to 96365

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 96365
CodeHow it relatesOffice range, Delaware
Add-on codes
96366IV infusion add-on hour, therapeutic or diagnostic, each additional hourAdd-on for additional time after the first hour of a therapeutic infusion.$21.19
96367Sequential IV infusion, additional drug, up to one hourAdd-on for a sequential infusion of a different drug after the initial infusion.$29.45
96368Concurrent infusion, additional IV substanceAdd-on for a concurrent drug infusion running alongside the initial infusion.$20.53
96375IV push add-on, each additional new drug, sequentialAdd-on for an IV push of a different drug during the encounter.$15.54
96361IV hydration, each additional hourHydration add-on when separately indicated hydration meets its time requirement alongside therapeutic administration.$12.89
Used instead
96374IV push, single or initial IV pushInitial IV push for a drug administered in 15 minutes or less.$37.33
96360Hydration infusion, initial serviceInitial hydration infusion when the service is hydration rather than drug administration.$33.07
96413Chemo IV infusion, initial drug, first hourInitial IV infusion for drugs classified for chemotherapy or complex biologic administration.$131.62

How 96365 has changed in Delaware

96365 · Office / nonfacility

$66.33

Effective 2026-10-01

The base rate is $8.83 higher than on 2025-10-01, moving from $57.50 to $66.33 (15.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $57.50changed to$66.33

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.54 changed to 1.76
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $62.14changed to$57.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.63 changed to 1.54

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $61.13changed to$62.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $65.08changed to$61.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.66 changed to 1.63
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $70.48changed to$65.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.75 changed to 1.66
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $74.99changed to$70.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.86 changed to 1.75

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $73.58changed to$74.99

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.74 changed to 1.86
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $74.24changed to$73.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.77 changed to 1.74
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $75.62changed to$74.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.81 changed to 1.77

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $71.73changed to$75.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.70 changed to 1.81
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $71.91changed to$71.73

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $72.54changed to$71.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.71 changed to 1.70

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $72.18changed to$72.54

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $71.03changed to$72.18

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.68 changed to 1.71
    • Malpractice RVU 0.03 changed to 0.04
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $78.25changed to$71.03

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.98 changed to 1.68
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $78.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$66.33Not available in this settingRVU26D
2026-07-01$66.33Not available in this settingRVU26C
2026-04-01$66.33Not available in this settingRVU26B
2026-01-01$66.33Not available in this settingRVU26A
2025-10-01$57.50Not available in this settingRVU25D
2025-07-01$57.50Not available in this settingRVU25C
2025-04-01$57.50Not available in this settingRVU25B
2025-01-01$57.50Not available in this settingRVU25A
2024-10-01$62.14Not available in this settingRVU24D
2024-07-01$62.14Not available in this settingRVU24C
2024-04-01$62.14Not available in this settingRVU24B
2024-03-09$62.14Not available in this settingRVU24AR
2024-01-01$61.13Not available in this settingRVU24A
2023-10-01$65.08Not available in this settingRVU23D
2023-07-01$65.08Not available in this settingRVU23C
2023-04-01$65.08Not available in this settingRVU23B
2023-01-01$65.08Not available in this settingRVU23A
2022-10-01$70.48Not available in this settingRVU22D
2022-07-01$70.48Not available in this settingRVU22C
2022-04-01$70.48Not available in this settingRVU22B
2022-01-01$70.48Not available in this settingRVU22A
2021-10-01$74.99Not available in this settingRVU21D
2021-07-01$74.99Not available in this settingRVU21C
2021-04-01$74.99Not available in this settingRVU21B
2021-01-01$74.99Not available in this settingRVU21A
2020-10-01$73.58Not available in this settingRVU20D
2020-07-01$73.58Not available in this settingRVU20C
2020-04-01$73.58Not available in this settingRVU20B
2020-01-01$73.58Not available in this settingRVU20A
2019-10-01$74.24Not available in this settingRVU19D
2019-07-01$74.24Not available in this settingRVU19C
2019-04-01$74.24Not available in this settingRVU19B
2019-01-01$74.24Not available in this settingRVU19A
2018-10-01$75.62Not available in this settingRVU18D
2018-07-01$75.62Not available in this settingRVU18C
2018-04-01$75.62Not available in this settingRVU18B
2018-01-01$75.62Not available in this settingRVU18AR1
2017-10-01$71.73Not available in this settingRVU17D
2017-07-01$71.73Not available in this settingRVU17C
2017-04-01$71.73Not available in this settingRVU17B
2017-01-01$71.73Not available in this settingRVU17A
2016-10-01$71.91Not available in this settingRVU16D
2016-07-01$71.91Not available in this settingRVU16C
2016-04-01$71.91Not available in this settingRVU16B
2016-01-01$71.91Not available in this settingRVU16A
2015-10-01$72.54Not available in this settingRVU15D
2015-07-01$72.54Not available in this settingRVU15C
2015-04-01$72.18Not available in this settingRVU15B
2015-01-01$72.18Not available in this settingRVU15A
2014-10-01$71.03Not available in this settingRVU14D
2014-07-01$71.03Not available in this settingRVU14C
2014-04-01$71.03Not available in this settingRVU14B
2014-01-01$71.03Not available in this settingRVU14A
2013-10-01$78.25Not available in this settingRVU13D
2013-07-01$78.25Not available in this settingRVU13C
2013-04-01$78.25Not available in this settingRVU13B
2013-01-01$78.25Not available in this settingRVU13AR

Price 96365 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

96365 billing questions

What is the minimum infusion time for this code?

The infusion must last more than 15 minutes. If administration takes 15 minutes or less, report the appropriate IV push code instead; documented start and stop times support the choice.

When do I add 96366?

Add 96366 when the same infusion continues beyond the first hour by more than 30 minutes. The first add-on unit requires at least 91 minutes of total infusion time.

Can I bill 96365 twice on the same day?

Usually only one initial administration service is reported per encounter. Another may be supported by a separate encounter or a protocol requiring distinct IV sites; document the circumstances and use an appropriate distinct-service modifier when required.

Is an office E/M visit separately billable with 96365?

Yes, when a significant, separately identifiable E/M service is documented; append modifier 25 to the E/M code. Routine infusion assessment and monitoring are included in 96365.

How is a second drug given after the first infusion reported?

Report 96367 for a sequential infusion of a different drug lasting more than 15 minutes, or 96375 if the new drug is given by IV push. Use 96368 for a qualifying concurrent infusion.

Should a monoclonal antibody or biologic be billed with 96365?

The administration code depends on the drug’s classification. Infusions classified for chemotherapy or complex biologic administration use codes such as 96413 rather than 96365.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 96365PPRRVU2026_Oct_nonQPP.csv, line 12,779 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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