CPT code 96369: Subcutaneous infusion, initial, up to one hour2026 Medicare rate & RVUs in Houston, TX
Reports the initial, up-to-one-hour service for a therapeutic or prophylactic medication delivered by subcutaneous infusion rather than a single injection.
In Houston, TX, Medicare pays $144.43 for 96369 in the office.
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.
On this page 11 sections
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 Houston, TX 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. Houston, TX pays $144.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Houston, TX · this page$144.43
- Austin, TX · Texas$152.80+$8.37
- Beaumont, TX · Texas$132.56−$11.87
- Brazoria, TX · Texas$143.56−$0.87
- Dallas, TX · Texas$144.33−$0.10
- Fort Worth, TX · Texas$142.98−$1.45
- Galveston, TX · Texas$143.89−$0.54
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $137.88 | — |
| Los Angeles, CACalifornia | $169.97 | — |
| Washington, DC areaDistrict of Columbia | $169.83 | — |
| Miami, FLFlorida | $152.11 | — |
| Chicago, ILIllinois | $146.99 | — |
| Manhattan, NYNew York | $168.18 | — |
| AlaskaAlaska | $156.92 | — |
| 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 | — |
| Madera, CACalifornia | $157.76 | — |
| Merced, CACalifornia | $157.76 | — |
| Modesto, CACalifornia | $157.76 | — |
| Napa, CACalifornia | $188.46 | — |
| Oxnard, CACalifornia | $169.70 | — |
| Redding, CACalifornia | $157.76 | — |
| Rest of CaliforniaCalifornia | $157.76 | — |
| Riverside, CACalifornia | $158.09 | — |
| Sacramento, CACalifornia | $167.07 | — |
| Salinas, CACalifornia | $166.49 | — |
| San Diego, CACalifornia | $171.55 | — |
| Marin County, CACalifornia | $201.23 | — |
| San Francisco, CACalifornia | $201.20 | — |
| San Benito County, CACalifornia | $205.80 | — |
| Santa Clara County, CACalifornia | $205.66 | — |
| San Luis Obispo, CACalifornia | $163.65 | — |
| Santa Cruz, CACalifornia | $174.09 | — |
| Santa Maria, CACalifornia | $167.42 | — |
| Santa Rosa, CACalifornia | $175.93 | — |
| Stockton, CACalifornia | $157.76 | — |
| Vallejo, CACalifornia | $188.41 | — |
| Visalia, CACalifornia | $157.76 | — |
| Yuba City, CACalifornia | $157.76 | — |
| ColoradoColorado | $153.59 | — |
| ConnecticutConnecticut | $155.86 | — |
| DelawareDelaware | $143.25 | — |
| Fort Lauderdale, FLFlorida | $147.55 | — |
| Rest of FloridaFlorida | $139.44 | — |
| Atlanta, GAGeorgia | $147.37 | — |
| Rest of GeorgiaGeorgia | $130.36 | — |
| Hawaii, Guam, HIHawaii | $163.30 | — |
| IowaIowa | $132.72 | — |
| IdahoIdaho | $133.48 | — |
| East St. Louis, ILIllinois | $135.02 | — |
| Rest of IllinoisIllinois | $133.61 | — |
| Suburban Chicago, ILIllinois | $149.48 | — |
| IndianaIndiana | $134.45 | — |
| KansasKansas | $131.32 | — |
| KentuckyKentucky | $129.67 | — |
| New Orleans, LALouisiana | $137.02 | — |
| Rest of LouisianaLouisiana | $129.17 | — |
| Metropolitan Boston, MAMassachusetts | $171.70 | — |
| Rest of MassachusettsMassachusetts | $152.13 | — |
| Baltimore area, MDMaryland | $155.31 | — |
| Rest of MarylandMaryland | $146.59 | — |
| Rest of MaineMaine | $133.63 | — |
| Southern Maine, MEMaine | $143.36 | — |
| Detroit, MIMichigan | $140.85 | — |
| Rest of MichiganMichigan | $133.18 | — |
| MinnesotaMinnesota | $148.23 | — |
| Metropolitan Kansas City, MOMissouri | $136.58 | — |
| Metropolitan St. Louis, MOMissouri | $138.39 | — |
| Rest of MissouriMissouri | $126.04 | — |
| MississippiMississippi | $125.66 | — |
| MontanaMontana | $144.96 | — |
| North CarolinaNorth Carolina | $135.42 | — |
| North DakotaNorth Dakota | $144.36 | — |
| NebraskaNebraska | $133.79 | — |
| New HampshireNew Hampshire | $150.45 | — |
| Northern New JerseyNew Jersey | $167.38 | — |
| Rest of New JerseyNew Jersey | $157.94 | — |
| New MexicoNew Mexico | $133.79 | — |
| NevadaNevada | $144.93 | — |
| NYC suburbs and Long Island, NYNew York | $172.15 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $158.50 | — |
| Queens, NYNew York | $170.78 | — |
| Rest of New YorkNew York | $137.82 | — |
| OhioOhio | $133.05 | — |
| OklahomaOklahoma | $130.08 | — |
| Portland, OROregon | $160.02 | — |
| Rest of OregonOregon | $144.11 | — |
| Metropolitan Philadelphia, PAPennsylvania | $150.89 | — |
| Rest of PennsylvaniaPennsylvania | $133.68 | — |
| Puerto RicoPuerto Rico | $146.45 | — |
| Rhode IslandRhode Island | $149.50 | — |
| South CarolinaSouth Carolina | $134.40 | — |
| South DakotaSouth Dakota | $144.29 | — |
| TennesseeTennessee | $132.03 | — |
| UtahUtah | $136.64 | — |
| VirginiaVirginia | $142.34 | — |
| Virgin Islands, VIUnited States Virgin Islands | $146.45 | — |
| VermontVermont | $143.10 | — |
| Rest of WashingtonWashington | $152.07 | — |
| King County, WAWashington | $176.21 | — |
| WisconsinWisconsin | $138.51 | — |
| West VirginiaWest Virginia | $127.45 | — |
| WyomingWyoming | $144.70 | — |
96369 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $156.92 | 1 |
| AL | $127.41 | 1 |
| AR | $125.16 | 1 |
| AZ | $140.57 | 1 |
| CA | $157.76–$205.80 | 29 |
| CO | $153.59 | 1 |
| CT | $155.86 | 1 |
| DC | $169.83 | 1 |
| DE | $143.25 | 1 |
| FL | $139.44–$152.11 | 3 |
| GA | $130.36–$147.37 | 2 |
| GU | $163.30 | 1 |
| HI | $163.30 | 1 |
| IA | $132.72 | 1 |
| ID | $133.48 | 1 |
| IL | $133.61–$149.48 | 4 |
| IN | $134.45 | 1 |
| KS | $131.32 | 1 |
| KY | $129.67 | 1 |
| LA | $129.17–$137.02 | 2 |
| MA | $152.13–$171.70 | 2 |
| MD | $146.59–$169.83 | 3 |
| ME | $133.63–$143.36 | 2 |
| MI | $133.18–$140.85 | 2 |
| MN | $148.23 | 1 |
| MO | $126.04–$138.39 | 3 |
| MS | $125.66 | 1 |
| MT | $144.96 | 1 |
| NC | $135.42 | 1 |
| ND | $144.36 | 1 |
| NE | $133.79 | 1 |
| NH | $150.45 | 1 |
| NJ | $157.94–$167.38 | 2 |
| NM | $133.79 | 1 |
| NV | $144.93 | 1 |
| NY | $137.82–$172.15 | 5 |
| OH | $133.05 | 1 |
| OK | $130.08 | 1 |
| OR | $144.11–$160.02 | 2 |
| PA | $133.68–$150.89 | 2 |
| PR | $146.45 | 1 |
| RI | $149.50 | 1 |
| SC | $134.40 | 1 |
| SD | $144.29 | 1 |
| TN | $132.03 | 1 |
| TX | $132.56–$152.80 | 8 |
| UT | $136.64 | 1 |
| VA | $142.34–$169.83 | 2 |
| VI | $146.45 | 1 |
| VT | $143.10 | 1 |
| WA | $152.07–$176.21 | 2 |
| WI | $138.51 | 1 |
| WV | $127.45 | 1 |
| WY | $144.70 | 1 |
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
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 Houston, TX 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
102
- Locality
- Houston, TX
- Physician work
- 1.008
- Practice expense
- 0.993
- Malpractice
- 1.376
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.21 | × 1.008 | 0.2117 |
| Practice expense | 4.10 | × 0.993 | 4.0713 |
| Malpractice | 0.03 | × 1.376 | 0.0413 |
| Total RVUs | 4.3243 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Houston, TX$144.43
Office: (0.21 × 1.008 + 4.1 × 0.993 + 0.03 × 1.376) × $33.4009 = $144.43
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
How 96369 has changed in Houston, TX
96369 · Office / nonfacility
$144.43
Effective 2026-10-01
The base rate is $9.32 higher than on 2025-10-01, moving from $135.11 to $144.43 (6.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$135.11changed to$144.43
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 3.91 changed to 4.10
- Work GPCI 1.014 changed to 1.008
- Practice expense GPCI 1.003 changed to 0.993
- Malpractice GPCI 1.409 changed to 1.376
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$142.04changed to$135.11
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.00 changed to 3.91
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$139.73changed to$142.04
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$144.15changed to$139.73
- 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
- Work GPCI 1.023 changed to 1.014
- Practice expense GPCI 1.016 changed to 1.003
- Malpractice GPCI 1.154 changed to 1.409
January 1, 2023
RVU23A
$151.99changed to$144.15
- 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
- Work GPCI 1.032 changed to 1.023
- Practice expense GPCI 1.029 changed to 1.016
- Malpractice GPCI 0.900 changed to 1.154
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$163.30changed to$151.99
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.32 changed to 4.04
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$165.26changed to$163.30
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 4.26 changed to 4.32
- Work GPCI 1.026 changed to 1.032
- Practice expense GPCI 1.020 changed to 1.029
- Malpractice GPCI 0.918 changed to 0.900
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$171.06changed to$165.26
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 4.46 changed to 4.26
- Work GPCI 1.020 changed to 1.026
- Practice expense GPCI 1.012 changed to 1.020
- Malpractice GPCI 0.936 changed to 0.918
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$178.86changed to$171.06
- 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.
January 1, 2018
RVU18AR1
$182.16changed to$178.86
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.79 changed to 4.67
- Practice expense GPCI 1.009 changed to 1.012
- Malpractice GPCI 0.946 changed to 0.936
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$195.27changed to$182.16
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 5.18 changed to 4.79
- Work GPCI 1.019 changed to 1.020
- Practice expense GPCI 1.006 changed to 1.009
- Malpractice GPCI 0.955 changed to 0.946
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$198.14changed to$195.27
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 5.24 changed to 5.18
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$197.15changed to$198.14
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$195.66changed to$197.15
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.20 changed to 5.24
- Work GPCI 1.014 changed to 1.019
- Practice expense GPCI 1.004 changed to 1.006
- Malpractice GPCI 0.939 changed to 0.955
Held through RVU15B.
January 1, 2014
RVU14A
$212.70changed to$195.66
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.00 changed to 5.20
- Work GPCI 1.009 changed to 1.014
- Practice expense GPCI 1.002 changed to 1.004
- Malpractice GPCI 0.923 changed to 0.939
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $212.70
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $144.43 | Not available in this setting | RVU26D |
| 2026-07-01 | $144.43 | Not available in this setting | RVU26C |
| 2026-04-01 | $144.43 | Not available in this setting | RVU26B |
| 2026-01-01 | $144.43 | Not available in this setting | RVU26A |
| 2025-10-01 | $135.11 | Not available in this setting | RVU25D |
| 2025-07-01 | $135.11 | Not available in this setting | RVU25C |
| 2025-04-01 | $135.11 | Not available in this setting | RVU25B |
| 2025-01-01 | $135.11 | Not available in this setting | RVU25A |
| 2024-10-01 | $142.04 | Not available in this setting | RVU24D |
| 2024-07-01 | $142.04 | Not available in this setting | RVU24C |
| 2024-04-01 | $142.04 | Not available in this setting | RVU24B |
| 2024-03-09 | $142.04 | Not available in this setting | RVU24AR |
| 2024-01-01 | $139.73 | Not available in this setting | RVU24A |
| 2023-10-01 | $144.15 | Not available in this setting | RVU23D |
| 2023-07-01 | $144.15 | Not available in this setting | RVU23C |
| 2023-04-01 | $144.15 | Not available in this setting | RVU23B |
| 2023-01-01 | $144.15 | Not available in this setting | RVU23A |
| 2022-10-01 | $151.99 | Not available in this setting | RVU22D |
| 2022-07-01 | $151.99 | Not available in this setting | RVU22C |
| 2022-04-01 | $151.99 | Not available in this setting | RVU22B |
| 2022-01-01 | $151.99 | Not available in this setting | RVU22A |
| 2021-10-01 | $163.30 | Not available in this setting | RVU21D |
| 2021-07-01 | $163.30 | Not available in this setting | RVU21C |
| 2021-04-01 | $163.30 | Not available in this setting | RVU21B |
| 2021-01-01 | $163.30 | Not available in this setting | RVU21A |
| 2020-10-01 | $165.26 | Not available in this setting | RVU20D |
| 2020-07-01 | $165.26 | Not available in this setting | RVU20C |
| 2020-04-01 | $165.26 | Not available in this setting | RVU20B |
| 2020-01-01 | $165.26 | Not available in this setting | RVU20A |
| 2019-10-01 | $171.06 | Not available in this setting | RVU19D |
| 2019-07-01 | $171.06 | Not available in this setting | RVU19C |
| 2019-04-01 | $171.06 | Not available in this setting | RVU19B |
| 2019-01-01 | $171.06 | Not available in this setting | RVU19A |
| 2018-10-01 | $178.86 | Not available in this setting | RVU18D |
| 2018-07-01 | $178.86 | Not available in this setting | RVU18C |
| 2018-04-01 | $178.86 | Not available in this setting | RVU18B |
| 2018-01-01 | $178.86 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $182.16 | Not available in this setting | RVU17D |
| 2017-07-01 | $182.16 | Not available in this setting | RVU17C |
| 2017-04-01 | $182.16 | Not available in this setting | RVU17B |
| 2017-01-01 | $182.16 | Not available in this setting | RVU17A |
| 2016-10-01 | $195.27 | Not available in this setting | RVU16D |
| 2016-07-01 | $195.27 | Not available in this setting | RVU16C |
| 2016-04-01 | $195.27 | Not available in this setting | RVU16B |
| 2016-01-01 | $195.27 | Not available in this setting | RVU16A |
| 2015-10-01 | $198.14 | Not available in this setting | RVU15D |
| 2015-07-01 | $198.14 | Not available in this setting | RVU15C |
| 2015-04-01 | $197.15 | Not available in this setting | RVU15B |
| 2015-01-01 | $197.15 | Not available in this setting | RVU15A |
| 2014-10-01 | $195.66 | Not available in this setting | RVU14D |
| 2014-07-01 | $195.66 | Not available in this setting | RVU14C |
| 2014-04-01 | $195.66 | Not available in this setting | RVU14B |
| 2014-01-01 | $195.66 | Not available in this setting | RVU14A |
| 2013-10-01 | $212.70 | Not available in this setting | RVU13D |
| 2013-07-01 | $212.70 | Not available in this setting | RVU13C |
| 2013-04-01 | $212.70 | Not available in this setting | RVU13B |
| 2013-01-01 | $212.70 | Not available in this setting | RVU13AR |
Where the Houston, TX rate applies
Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- 96369 in Houston · multiple payment areas
- Aldine
- Atascocita
- Barrett
- 96369 in Baytown · multiple payment areas
- Bellaire
- Bunker Hill Village
- Channelview
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
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