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CPT code 96369: Subcutaneous infusion, initial, up to one hour2026 Medicare rate & RVUs in New Mexico

Reports the initial, up-to-one-hour service for a therapeutic or prophylactic medication delivered by subcutaneous infusion rather than a single injection.

CMS RVU26DEffective Oct 1, 2026One payment locality7.1K Medicare services in 2024

In New Mexico, Medicare pays $133.79 for 96369 in the office.

$133.79Office (non-facility)
Not available in this settingHospital or facility
−7.7%vs the national office rate ($144.96)

Check a contract rate as a % of Medicare · 96369 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 96369 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 96369 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 96369 covers

This service covers starting a therapeutic or prophylactic medication infusion through a subcutaneous site, including setting up the infusion and establishing the site or sites. It is distinct from a one-time subcutaneous injection: the medication is delivered by infusion, commonly using an infusion pump. In an office setting, clinical staff may perform the administration as part of the physician-supervised service.

Report 96369 for the initial infusion service, up to one hour; documentation should support the medication, subcutaneous route, infusion start and stop times, and work performed to establish the infusion. For Medicare, this is an incident-to service and may be billed only when performed under physician supervision. The drug itself is not the administration service represented by this code; report it separately when appropriate under the applicable drug billing rules.

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 New Mexico compares for 96369

Across 109 of 109 payment localities, the office rate for 96369 runs from $125.16 in Arkansas to $205.80 in San Benito County, CA. New Mexico pays $133.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

96369 in New Mexico vs other payment areas
  1. New Mexico · this page$133.79
  2. Los Angeles, CA · California$169.97+$36.18
  3. Washington, DC area · District of Columbia$169.83+$36.04
  4. Miami, FL · Florida$152.11+$18.32
  5. Chicago, IL · Illinois$146.99+$13.20
  6. Manhattan, NY · New York$168.18+$34.39
  7. Alaska · Alaska$156.92+$23.13

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

Every other payment area

96369 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$127.41—
ArkansasArkansas$125.16—
ArizonaArizona$140.57—
Bakersfield, CACalifornia$157.85—
Chico, CACalifornia$157.76—
El Centro, CACalifornia$157.77—
Fresno, CACalifornia$157.76—
Hanford, CACalifornia$157.76—

96369 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.

$125.16

$181.78

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

View every state and territory as a table
96369 office rate range by state
State / territoryOffice rate rangeLocalities
AK$156.921
AL$127.411
AR$125.161
AZ$140.571
CA$157.76–$205.8029
CO$153.591
CT$155.861
DC$169.831
DE$143.251
FL$139.44–$152.113
GA$130.36–$147.372
GU$163.301
HI$163.301
IA$132.721
ID$133.481
IL$133.61–$149.484
IN$134.451
KS$131.321
KY$129.671
LA$129.17–$137.022
MA$152.13–$171.702
MD$146.59–$169.833
ME$133.63–$143.362
MI$133.18–$140.852
MN$148.231
MO$126.04–$138.393
MS$125.661
MT$144.961
NC$135.421
ND$144.361
NE$133.791
NH$150.451
NJ$157.94–$167.382
NM$133.791
NV$144.931
NY$137.82–$172.155
OH$133.051
OK$130.081
OR$144.11–$160.022
PA$133.68–$150.892
PR$146.451
RI$149.501
SC$134.401
SD$144.291
TN$132.031
TX$132.56–$152.808
UT$136.641
VA$142.34–$169.832
VI$146.451
VT$143.101
WA$152.07–$176.212
WI$138.511
WV$127.451
WY$144.701

See 96369 in every payment locality

How the 96369 rate is calculated

Each of 96369’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 · 96369

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.21

0.21 RVUs× 1.000 GPCI

Practice expense4.10

4.10 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

4.3400

Conversion factor

$33.4009

Medicare rate

$144.96

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,783

Code
96369
Physician work
0.21
Practice expense
4.10
Malpractice
0.03

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 96369 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0000.2100
Practice expense4.10× 0.9173.7597
Malpractice0.03× 1.2010.0360
Total RVUs4.0057
Conversion factor× 33.4009

Office rate, New Mexico$133.79

Office: (0.21 × 1 + 4.1 × 0.917 + 0.03 × 1.201) × $33.4009 = $133.79

Open 96369 in the RVU calculator

Payment rules and modifiers for 96369

The CMS indicators that decide how 96369 is paid alongside other services.

CMS payment indicators · 96369

Subcutaneous infusion, initial, up to one 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 96369

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

Codes related to 96369
CodeHow it relatesOffice range, New Mexico
Add-on codes
96370Subcutaneous infusion, each additional hourAdd-on code for qualifying additional time beyond the initial subcutaneous infusion service.$16.21
96371Infusion setup, additional pump setup or siteAdd-on code for an additional subcutaneous infusion pump setup or site establishment.$51.76
Used instead
96372SC/IM injection, therapeutic, prophylactic, or diagnosticUse for a subcutaneous or intramuscular injection rather than a subcutaneous infusion.$14.66
96365IV drug infusion, initial, first hourReports an initial therapeutic, prophylactic, or diagnostic infusion by the intravenous route.$62.53

How 96369 has changed in New Mexico

96369 · Office / nonfacility

$133.79

Effective 2026-10-01

The base rate is $11.02 higher than on 2025-10-01, moving from $122.77 to $133.79 (9.0%).

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

    $122.77changed to$133.79

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.91 changed to 4.10
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $129.06changed to$122.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.00 changed to 3.91

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $126.95changed to$129.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $128.83changed to$126.95

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.93 changed to 4.00
    • Malpractice RVU 0.04 changed to 0.03
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $133.34changed to$128.83

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.04 changed to 3.93
    • Malpractice RVU 0.02 changed to 0.04
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $143.20changed to$133.34

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.32 changed to 4.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $148.05changed to$143.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.26 changed to 4.32
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $156.50changed to$148.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.46 changed to 4.26
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $163.74changed to$156.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.67 changed to 4.46
    • Malpractice RVU 0.03 changed to 0.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $166.99changed to$163.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.79 changed to 4.67
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $179.21changed to$166.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.18 changed to 4.79
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $181.84changed to$179.21

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.24 changed to 5.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $180.93changed to$181.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $179.69changed to$180.93

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.20 changed to 5.24
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $195.15changed to$179.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.00 changed to 5.20
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $195.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$133.79Not available in this settingRVU26D
2026-07-01$133.79Not available in this settingRVU26C
2026-04-01$133.79Not available in this settingRVU26B
2026-01-01$133.79Not available in this settingRVU26A
2025-10-01$122.77Not available in this settingRVU25D
2025-07-01$122.77Not available in this settingRVU25C
2025-04-01$122.77Not available in this settingRVU25B
2025-01-01$122.77Not available in this settingRVU25A
2024-10-01$129.06Not available in this settingRVU24D
2024-07-01$129.06Not available in this settingRVU24C
2024-04-01$129.06Not available in this settingRVU24B
2024-03-09$129.06Not available in this settingRVU24AR
2024-01-01$126.95Not available in this settingRVU24A
2023-10-01$128.83Not available in this settingRVU23D
2023-07-01$128.83Not available in this settingRVU23C
2023-04-01$128.83Not available in this settingRVU23B
2023-01-01$128.83Not available in this settingRVU23A
2022-10-01$133.34Not available in this settingRVU22D
2022-07-01$133.34Not available in this settingRVU22C
2022-04-01$133.34Not available in this settingRVU22B
2022-01-01$133.34Not available in this settingRVU22A
2021-10-01$143.20Not available in this settingRVU21D
2021-07-01$143.20Not available in this settingRVU21C
2021-04-01$143.20Not available in this settingRVU21B
2021-01-01$143.20Not available in this settingRVU21A
2020-10-01$148.05Not available in this settingRVU20D
2020-07-01$148.05Not available in this settingRVU20C
2020-04-01$148.05Not available in this settingRVU20B
2020-01-01$148.05Not available in this settingRVU20A
2019-10-01$156.50Not available in this settingRVU19D
2019-07-01$156.50Not available in this settingRVU19C
2019-04-01$156.50Not available in this settingRVU19B
2019-01-01$156.50Not available in this settingRVU19A
2018-10-01$163.74Not available in this settingRVU18D
2018-07-01$163.74Not available in this settingRVU18C
2018-04-01$163.74Not available in this settingRVU18B
2018-01-01$163.74Not available in this settingRVU18AR1
2017-10-01$166.99Not available in this settingRVU17D
2017-07-01$166.99Not available in this settingRVU17C
2017-04-01$166.99Not available in this settingRVU17B
2017-01-01$166.99Not available in this settingRVU17A
2016-10-01$179.21Not available in this settingRVU16D
2016-07-01$179.21Not available in this settingRVU16C
2016-04-01$179.21Not available in this settingRVU16B
2016-01-01$179.21Not available in this settingRVU16A
2015-10-01$181.84Not available in this settingRVU15D
2015-07-01$181.84Not available in this settingRVU15C
2015-04-01$180.93Not available in this settingRVU15B
2015-01-01$180.93Not available in this settingRVU15A
2014-10-01$179.69Not available in this settingRVU14D
2014-07-01$179.69Not available in this settingRVU14C
2014-04-01$179.69Not available in this settingRVU14B
2014-01-01$179.69Not available in this settingRVU14A
2013-10-01$195.15Not available in this settingRVU13D
2013-07-01$195.15Not available in this settingRVU13C
2013-04-01$195.15Not available in this settingRVU13B
2013-01-01$195.15Not available in this settingRVU13AR

Price 96369 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

96369 billing questions

When should 96369 be used instead of 96372?

Use 96369 for a medication delivered through a subcutaneous infusion. Use 96372 for a therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injection, not an infusion.

What documentation supports 96369?

Document the drug, subcutaneous route, infusion start and stop times, and establishment of the infusion site. The record should distinguish the infusion from a single injection.

Can 96369 be reported for additional infusion time?

96369 represents the initial service up to one hour. Report 96370 for qualifying additional infusion time, following the applicable CPT timing instructions.

Can 96369 be billed when staff perform the infusion?

For Medicare, the service is incident-to and may be billed only when performed under physician supervision.

Is the medication included in 96369?

96369 represents the administration service, not the medication itself. Report the drug separately when appropriate under the applicable drug billing rules.

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 96369PPRRVU2026_Oct_nonQPP.csv, line 12,783 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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