CPT code 96401: Chemotherapy injection, subcutaneous or intramuscular, nonhormonal2026 Medicare rate & RVUs

Medicare pays $71.81 for 96401 nationally in the office. Local office rates run $62.22–$100.01.

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

What 96401 covers

Trained oncology staff administer nonhormonal antineoplastic medication beneath the skin or into muscle, most often in a physician's oncology or hematology office. Examples include subcutaneous bortezomib for multiple myeloma and azacitidine for myelodysplastic syndromes; qualifying subcutaneous antibody formulations include daratumumab with hyaluronidase. Nursing work includes verifying the agent and dose, administering the injection, and monitoring the patient for a reaction.

Choose 96401 for qualifying subcutaneous or intramuscular nonhormonal antineoplastic administration, rather than hormonal injections under 96402 or routine therapeutic injections under 96372. The administration is separate from the drug supply, which is reported with its appropriate HCPCS code and documented dose. Record the medication, dose, route, injection site, date, and supervising physician. CMS classifies 96401 as an incident-to service; billing under the physician requires physician supervision. A significant, separately identifiable E/M service may be reported with modifier 25 on the E/M code when documentation supports work beyond the injection encounter.

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.

Where 96401 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96401 rates by state

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

How the 96401 rate is calculated

Each of 96401’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.

Payment rules and modifiers for 96401

The CMS indicators that decide how 96401 is paid alongside other services.

96401 compared with similar codes

How to choose

96402Hormonal therapy injectionSubcutaneous or intramuscular

96402 is for hormonal antineoplastics such as leuprolide, goserelin, or fulvestrant; 96401 is for qualifying nonhormonal agents such as bortezomib or azacitidine.

96372SC/IM injectionTherapeutic, prophylactic, or diagnostic

96372 covers routine SC/IM therapeutic injections, including methotrexate given for rheumatoid arthritis. Use 96401 when a nonhormonal SC/IM injection qualifies as chemotherapy administration.

96409Chemotherapy pushSingle or initial drug

96409 is for an antineoplastic drug given by IV push; 96401 applies to qualifying subcutaneous or intramuscular injection.

96405Intralesional chemotherapyUp to seven lesions

96405 is for chemotherapy injected directly into up to seven lesions; 96401 is for a qualifying subcutaneous or intramuscular injection rather than intralesional delivery.

Codes related to 96401

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

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

Open CMS sourceHow we calculate rates