CPT code 96371: Infusion setup, additional pump setup or site2026 Medicare rate & RVUs in Utah

Reports an additional pump setup or newly established subcutaneous infusion site during a therapeutic, prophylactic, or diagnostic subcutaneous infusion.

CMS RVU26DEffective Oct 1, 2026One payment locality970 Medicare services in 2024

In Utah, Medicare pays $53.06 for 96371 in the office.

$53.06Office (non-facility)
Not available in this settingHospital or facility
−6.0%vs the national office rate ($56.45)

Check a contract rate as a % of Medicare · 96371 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 96371 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 96371 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 96371 covers

This add-on captures an additional pump setup or establishment of a new subcutaneous infusion site during a therapeutic, prophylactic, or diagnostic infusion. It represents setup or site work, not additional infusion time. Clinical staff commonly perform the hands-on work in an office or infusion setting.

Report 96371 only with a primary subcutaneous infusion service, such as 96369 or 96370, when the additional setup or site is performed. Document the infusion and the additional pump setup or site established. CMS classifies 96371 as an add-on, billed only with a primary procedure and paid within that procedure’s global period. As an incident-to service, it may be billed only when performed under physician supervision.

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 Utah compares for 96371

Across 109 of 109 payment localities, the office rate for 96371 runs from $48.49 in Arkansas to $81.40 in Santa Clara County, CA. Utah pays $53.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

96371 in Utah vs other payment areas
  1. Utah · this page$53.06
  2. Los Angeles, CA · California$66.78+$13.72
  3. Washington, DC area · District of Columbia$66.50+$13.44
  4. Miami, FL · Florida$58.76+$5.70
  5. Chicago, IL · Illinois$56.73+$3.67
  6. Manhattan, NY · New York$65.59+$12.53
  7. Alaska · Alaska$60.12+$7.06

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

Every other payment area

96371 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$49.39—
ArkansasArkansas$48.49—
ArizonaArizona$54.70—
Bakersfield, CACalifornia$61.87—
Chico, CACalifornia$61.87—
El Centro, CACalifornia$61.87—
Fresno, CACalifornia$61.87—
Hanford, CACalifornia$61.87—

96371 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.

$48.49

$71.64

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

View every state and territory as a table
96371 office rate range by state
State / territoryOffice rate rangeLocalities
AK$60.121
AL$49.391
AR$48.491
AZ$54.701
CA$61.87–$81.4029
CO$60.061
CT$60.791
DC$66.501
DE$55.771
FL$53.96–$58.763
GA$50.35–$57.352
GU$64.181
HI$64.181
IA$51.651
ID$51.931
IL$51.54–$57.974
IN$52.331
KS$51.031
KY$50.181
LA$49.96–$53.122
MA$59.44–$67.402
MD$57.12–$66.503
ME$51.93–$55.942
MI$51.54–$54.472
MN$58.081
MO$48.66–$53.743
MS$48.601
MT$56.451
NC$52.671
ND$56.451
NE$52.101
NH$58.761
NJ$61.64–$65.482
NM$51.761
NV$56.501
NY$53.63–$67.125
OH$51.541
OK$50.411
OR$56.22–$62.712
PA$51.82–$58.762
PR$57.071
RI$58.311
SC$52.161
SD$56.451
TN$51.311
TX$51.37–$59.728
UT$53.061
VA$55.49–$66.502
VI$57.071
VT$55.881
WA$59.44–$69.262
WI$54.081
WV$49.051
WY$56.451

See 96371 in every payment locality

How the 96371 rate is calculated

Each of 96371’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 · 96371

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense1.69

1.69 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

1.6900

Conversion factor

$33.4009

Medicare rate

$56.45

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,785

Code
96371
Physician work
0.00
Practice expense
1.69
Malpractice
0.00

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 96371 in Utah
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense1.69× 0.9401.5886
Malpractice0.00× 0.8980.0000
Total RVUs1.5886
Conversion factor× 33.4009

Office rate, Utah$53.06

Office: (0 × 1 + 1.69 × 0.94 + 0 × 0.898) × $33.4009 = $53.06

Open 96371 in the RVU calculator

Payment rules and modifiers for 96371

The CMS indicators that decide how 96371 is paid alongside other services.

CMS payment indicators · 96371

Infusion setup, additional pump setup or site

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
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.

How 96371 has changed in Utah

96371 · Office / nonfacility

$53.06

Effective 2026-10-01

The base rate is $1.15 higher than on 2025-10-01, moving from $51.91 to $53.06 (2.2%).

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

    $51.91changed to$53.06

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.71 changed to 1.69
    • Malpractice RVU 0.01 changed to 0.00
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $56.21changed to$51.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.80 changed to 1.71

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $55.30changed to$56.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $52.72changed to$55.30

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.68 changed to 1.80
    • Malpractice RVU 0.00 changed to 0.01
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $55.02changed to$52.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.73 changed to 1.68
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $60.61changed to$55.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.89 changed to 1.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $59.63changed to$60.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.79 changed to 1.89
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $61.47changed to$59.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.84 changed to 1.79
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $60.07changed to$61.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.80 changed to 1.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $64.07changed to$60.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.93 changed to 1.80
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $67.67changed to$64.07

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.05 changed to 1.93
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $83.91changed to$67.67

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.52 changed to 2.05
    • Malpractice RVU 0.01 changed to 0.00

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $83.49changed to$83.91

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $83.70changed to$83.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.53 changed to 2.52
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $92.94changed to$83.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.97 changed to 2.53
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $92.94

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$53.06Not available in this settingRVU26D
2026-07-01$53.06Not available in this settingRVU26C
2026-04-01$53.06Not available in this settingRVU26B
2026-01-01$53.06Not available in this settingRVU26A
2025-10-01$51.91Not available in this settingRVU25D
2025-07-01$51.91Not available in this settingRVU25C
2025-04-01$51.91Not available in this settingRVU25B
2025-01-01$51.91Not available in this settingRVU25A
2024-10-01$56.21Not available in this settingRVU24D
2024-07-01$56.21Not available in this settingRVU24C
2024-04-01$56.21Not available in this settingRVU24B
2024-03-09$56.21Not available in this settingRVU24AR
2024-01-01$55.30Not available in this settingRVU24A
2023-10-01$52.72Not available in this settingRVU23D
2023-07-01$52.72Not available in this settingRVU23C
2023-04-01$52.72Not available in this settingRVU23B
2023-01-01$52.72Not available in this settingRVU23A
2022-10-01$55.02Not available in this settingRVU22D
2022-07-01$55.02Not available in this settingRVU22C
2022-04-01$55.02Not available in this settingRVU22B
2022-01-01$55.02Not available in this settingRVU22A
2021-10-01$60.61Not available in this settingRVU21D
2021-07-01$60.61Not available in this settingRVU21C
2021-04-01$60.61Not available in this settingRVU21B
2021-01-01$60.61Not available in this settingRVU21A
2020-10-01$59.63Not available in this settingRVU20D
2020-07-01$59.63Not available in this settingRVU20C
2020-04-01$59.63Not available in this settingRVU20B
2020-01-01$59.63Not available in this settingRVU20A
2019-10-01$61.47Not available in this settingRVU19D
2019-07-01$61.47Not available in this settingRVU19C
2019-04-01$61.47Not available in this settingRVU19B
2019-01-01$61.47Not available in this settingRVU19A
2018-10-01$60.07Not available in this settingRVU18D
2018-07-01$60.07Not available in this settingRVU18C
2018-04-01$60.07Not available in this settingRVU18B
2018-01-01$60.07Not available in this settingRVU18AR1
2017-10-01$64.07Not available in this settingRVU17D
2017-07-01$64.07Not available in this settingRVU17C
2017-04-01$64.07Not available in this settingRVU17B
2017-01-01$64.07Not available in this settingRVU17A
2016-10-01$67.67Not available in this settingRVU16D
2016-07-01$67.67Not available in this settingRVU16C
2016-04-01$67.67Not available in this settingRVU16B
2016-01-01$67.67Not available in this settingRVU16A
2015-10-01$83.91Not available in this settingRVU15D
2015-07-01$83.91Not available in this settingRVU15C
2015-04-01$83.49Not available in this settingRVU15B
2015-01-01$83.49Not available in this settingRVU15A
2014-10-01$83.70Not available in this settingRVU14D
2014-07-01$83.70Not available in this settingRVU14C
2014-04-01$83.70Not available in this settingRVU14B
2014-01-01$83.70Not available in this settingRVU14A
2013-10-01$92.94Not available in this settingRVU13D
2013-07-01$92.94Not available in this settingRVU13C
2013-04-01$92.94Not available in this settingRVU13B
2013-01-01$92.94Not available in this settingRVU13AR

Price 96371 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

96371 billing questions

When is 96371 reported with 96369 or 96370?

Report 96371 with a primary subcutaneous infusion service when an additional pump setup or new infusion site is established. The primary infusion code represents the infusion service; 96371 represents the additional setup or site work.

Is 96371 an additional-hour code?

No. It reports additional pump setup or establishment of a new subcutaneous infusion site, not another hour of infusion time. Use 96370 for qualifying additional infusion time.

What documentation supports 96371?

Document the subcutaneous infusion and the additional pump setup or newly established site. The record should make clear what additional setup or site work was performed.

Can 96371 be billed by itself?

No. CMS identifies 96371 as an add-on code that must be billed with a primary procedure, such as 96369 or 96370.

Who may perform the service for billing?

CMS identifies 96371 as an incident-to service. It may be billed only when performed under physician supervision.

How does 96371 differ from 96372?

96371 describes additional setup or a new site during a subcutaneous infusion. 96372 describes a therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injection.

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 96371PPRRVU2026_Oct_nonQPP.csv, line 12,785 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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