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

Report this service when a hormonal antineoplastic drug is administered by subcutaneous or intramuscular injection, such as in oncology treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality335.4K Medicare services in 2024

In Washington, DC area, Medicare pays $44.81 for 96402 in the office.

$44.81Office (non-facility)
Not available in this settingHospital or facility
+15.6%vs the national office rate ($38.75)

Check a contract rate as a % of Medicare · 96402 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 96402 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 96402 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 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.

How Washington, DC area compares for 96402

Across 109 of 109 payment localities, the office rate for 96402 runs from $33.95 in Arkansas to $53.16 in San Benito County, CA. Washington, DC area pays $44.81. The RVUs are the same everywhere; the geographic indexes change the dollars.

96402 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$44.81
  2. Los Angeles, CA · California$44.59−$0.22
  3. Miami, FL · Florida$41.07−$3.74
  4. Chicago, IL · Illinois$39.81−$5.00
  5. Manhattan, NY · New York$44.68−$0.13
  6. Alaska · Alaska$43.68−$1.13
  7. Alabama · Alabama$34.49−$10.32

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

96402 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$33.95—
ArizonaArizona$37.67—
Bakersfield, CACalifornia$41.65—
Chico, CACalifornia$41.59—
El Centro, CACalifornia$41.59—
Fresno, CACalifornia$41.59—
Hanford, CACalifornia$41.59—
Madera, CACalifornia$41.59—

96402 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.

$33.95

$47.38

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

View every state and territory as a table
96402 office rate range by state
State / territoryOffice rate rangeLocalities
AK$43.681
AL$34.491
AR$33.951
AZ$37.671
CA$41.59–$53.1629
CO$40.711
CT$41.461
DC$44.811
DE$38.331
FL$37.68–$41.073
GA$35.45–$39.412
GU$42.811
HI$42.811
IA$35.651
ID$35.851
IL$36.36–$40.164
IN$36.091
KS$35.371
KY$35.171
LA$35.07–$36.962
MA$40.39–$45.092
MD$39.13–$44.813
ME$35.95–$38.212
MI$36.07–$38.092
MN$39.191
MO$34.35–$37.223
MS$34.161
MT$38.741
NC$36.381
ND$38.351
NE$35.891
NH$39.961
NJ$41.98–$44.272
NM$36.251
NV$38.671
NY$36.96–$45.725
OH$35.991
OK$35.201
OR$38.42–$42.202
PA$36.11–$40.292
PR$39.081
RI$39.841
SC$36.231
SD$38.301
TN$35.551
TX$35.84–$40.528
UT$36.771
VA$38.01–$44.812
VI$39.081
VT$38.101
WA$40.35–$46.142
WI$36.951
WV$34.881
WY$38.571

See 96402 in every payment locality

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.

How the rate is built · 96402

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.19

0.19 RVUs× 1.000 GPCI

Practice expense0.95

0.95 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.1600

Conversion factor

$33.4009

Medicare rate

$38.75

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,796

Code
96402
Physician work
0.19
Practice expense
0.95
Malpractice
0.02

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 96402 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.19× 1.0540.2003
Practice expense0.95× 1.1781.1191
Malpractice0.02× 1.1130.0223
Total RVUs1.3416
Conversion factor× 33.4009

Office rate, Washington, DC area$44.81

Office: (0.19 × 1.054 + 0.95 × 1.178 + 0.02 × 1.113) × $33.4009 = $44.81

Open 96402 in the RVU calculator

Payment rules and modifiers for 96402

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

CMS payment indicators · 96402

Hormonal therapy injection, subcutaneous or intramuscular

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 96402

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

Codes related to 96402
CodeHow it relatesOffice range, Washington, DC area
Same family
96401Chemotherapy injection, subcutaneous or intramuscular, nonhormonalUses the same subcutaneous or intramuscular routes for nonhormonal antineoplastic agents.$83.64
Used instead
96372SC/IM injection, therapeutic, prophylactic, or diagnosticUsed for qualifying non-antineoplastic therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injections.$17.37
96409Chemotherapy push, single or initial drugAntineoplastic administration by intravenous push rather than subcutaneous or intramuscular injection.$122.03
96413Chemo IV infusion, initial drug, first hourAntineoplastic administration by intravenous infusion rather than subcutaneous or intramuscular injection.$155.68

How 96402 has changed in Washington, DC area

96402 · Office / nonfacility

$44.81

Effective 2026-10-01

The base rate is $4.01 higher than on 2025-10-01, moving from $40.80 to $44.81 (9.8%).

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

    $40.80changed to$44.81

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.87 changed to 0.95
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $41.19changed to$40.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.85 changed to 0.87

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $40.52changed to$41.19

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $40.54changed to$40.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.80 changed to 0.85
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $40.76changed to$40.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.77 changed to 0.80
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $39.81changed to$40.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.74 changed to 0.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $38.08changed to$39.81

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.68 changed to 0.74
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $36.71changed to$38.08

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.67 changed to 0.68
    • Malpractice RVU 0.01 changed to 0.02
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $36.67changed to$36.71

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $38.76changed to$36.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.71 changed to 0.67
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $38.27changed to$38.76

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.70 changed to 0.71
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $38.38changed to$38.27

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.71 changed to 0.70
    • Malpractice RVU 0.01 changed to 0.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $38.19changed to$38.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $37.29changed to$38.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.69 changed to 0.71
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $38.14changed to$37.29

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.76 changed to 0.69
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $38.14

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$44.81Not available in this settingRVU26D
2026-07-01$44.81Not available in this settingRVU26C
2026-04-01$44.81Not available in this settingRVU26B
2026-01-01$44.81Not available in this settingRVU26A
2025-10-01$40.80Not available in this settingRVU25D
2025-07-01$40.80Not available in this settingRVU25C
2025-04-01$40.80Not available in this settingRVU25B
2025-01-01$40.80Not available in this settingRVU25A
2024-10-01$41.19Not available in this settingRVU24D
2024-07-01$41.19Not available in this settingRVU24C
2024-04-01$41.19Not available in this settingRVU24B
2024-03-09$41.19Not available in this settingRVU24AR
2024-01-01$40.52Not available in this settingRVU24A
2023-10-01$40.54Not available in this settingRVU23D
2023-07-01$40.54Not available in this settingRVU23C
2023-04-01$40.54Not available in this settingRVU23B
2023-01-01$40.54Not available in this settingRVU23A
2022-10-01$40.76Not available in this settingRVU22D
2022-07-01$40.76Not available in this settingRVU22C
2022-04-01$40.76Not available in this settingRVU22B
2022-01-01$40.76Not available in this settingRVU22A
2021-10-01$39.81Not available in this settingRVU21D
2021-07-01$39.81Not available in this settingRVU21C
2021-04-01$39.81Not available in this settingRVU21B
2021-01-01$39.81Not available in this settingRVU21A
2020-10-01$38.08Not available in this settingRVU20D
2020-07-01$38.08Not available in this settingRVU20C
2020-04-01$38.08Not available in this settingRVU20B
2020-01-01$38.08Not available in this settingRVU20A
2019-10-01$36.71Not available in this settingRVU19D
2019-07-01$36.71Not available in this settingRVU19C
2019-04-01$36.71Not available in this settingRVU19B
2019-01-01$36.71Not available in this settingRVU19A
2018-10-01$36.67Not available in this settingRVU18D
2018-07-01$36.67Not available in this settingRVU18C
2018-04-01$36.67Not available in this settingRVU18B
2018-01-01$36.67Not available in this settingRVU18AR1
2017-10-01$38.76Not available in this settingRVU17D
2017-07-01$38.76Not available in this settingRVU17C
2017-04-01$38.76Not available in this settingRVU17B
2017-01-01$38.76Not available in this settingRVU17A
2016-10-01$38.27Not available in this settingRVU16D
2016-07-01$38.27Not available in this settingRVU16C
2016-04-01$38.27Not available in this settingRVU16B
2016-01-01$38.27Not available in this settingRVU16A
2015-10-01$38.38Not available in this settingRVU15D
2015-07-01$38.38Not available in this settingRVU15C
2015-04-01$38.19Not available in this settingRVU15B
2015-01-01$38.19Not available in this settingRVU15A
2014-10-01$37.29Not available in this settingRVU14D
2014-07-01$37.29Not available in this settingRVU14C
2014-04-01$37.29Not available in this settingRVU14B
2014-01-01$37.29Not available in this settingRVU14A
2013-10-01$38.14Not available in this settingRVU13D
2013-07-01$38.14Not available in this settingRVU13C
2013-04-01$38.14Not available in this settingRVU13B
2013-01-01$38.14Not available in this settingRVU13AR

Price 96402 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

96402 billing questions

How does this differ from 96401?

Use 96402 for a hormonal antineoplastic agent given subcutaneously or intramuscularly. Code 96401 is for a nonhormonal antineoplastic agent by those routes.

Can the drug be billed separately?

The administration code covers the injection service, not the medication. When the practice supplies the drug, report the appropriate drug code separately if applicable.

Can this be billed for any subcutaneous or intramuscular injection?

No. The agent must be a hormonal antineoplastic drug. A routine therapeutic injection, such as a non-antineoplastic medication, is not reported with this code.

What documentation supports reporting 96402?

Document the hormonal antineoplastic agent, its cancer-treatment indication, the subcutaneous or intramuscular route, and that the injection was administered.

What supervision is required for Medicare billing?

CMS specifies that this incident-to service is billed only when performed under physician supervision.

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 96402PPRRVU2026_Oct_nonQPP.csv, line 12,796 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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