CPT code 96402: Hormonal therapy injection, subcutaneous or intramuscular2026 Medicare rate & RVUs in California

Medicare pays $41.59–$53.16 for 96402 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

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

What 96402 covers

This service covers administration of a hormonal antineoplastic agent by subcutaneous or intramuscular injection. It is commonly performed in an oncology or urology practice for cancer treatment, including administration of agents such as leuprolide, goserelin, or fulvestrant when used as hormonal antineoplastic therapy. The code represents the administration service, not the drug itself.

Select this code based on the agent’s hormonal antineoplastic role and the injection route; a nonhormonal antineoplastic injection uses a different administration code. Record the medication, indication, route, and administration in the clinical documentation. The drug may be reported separately when the practice supplies it and applicable drug-coding requirements are met. Under the CMS rule for this service, it is billed as an incident-to service 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.

Where 96402 pays more and less in California

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

29 of 29 payment localities

How the 96402 rate is calculated

Each of 96402’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 96402

The CMS indicators that decide how 96402 is paid alongside other services.

96402 compared with similar codes

How to choose

96401Chemotherapy injectionSubcutaneous or intramuscular, nonhormonal

Both codes cover subcutaneous or intramuscular antineoplastic administration. Choose 96402 for a hormonal antineoplastic agent and 96401 for a nonhormonal agent.

96372SC/IM injectionTherapeutic, prophylactic, or diagnostic

Use 96372 for a qualifying therapeutic, prophylactic, or diagnostic injection that is not an antineoplastic administration. Use 96402 for a hormonal antineoplastic agent.

96409Chemotherapy pushSingle or initial drug

Code 96409 describes antineoplastic administration by intravenous push. Code 96402 applies when the hormonal antineoplastic agent is given subcutaneously or intramuscularly.

Codes related to 96402

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