CPT code 96409: Chemotherapy push, single or initial drug2026 Medicare rate & RVUs in Washington, DC area

Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug.

CMS RVU26DEffective Oct 1, 2026One payment locality37.4K Medicare services in 2024

In Washington, DC area, Medicare pays $122.03 for 96409 in the office.

$122.03Office (non-facility)
Not available in this settingHospital or facility
+16.7%vs the national office rate ($104.54)

Check a contract rate as a % of Medicare · 96409 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 96409 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 96409 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 96409 covers

This service covers administration of an antineoplastic drug through venous access by a brief intravenous push, rather than by a timed infusion. It is commonly performed by oncology nursing staff in an office or outpatient cancer clinic. The code represents one drug administered by this method; the drug itself is generally reported separately when separately payable and supported by the record.

Select this code when the documented route and method are intravenous push and the service is for a single or initial drug. The medication administration record should identify the drug, dose, route, and administration method; document additional drugs and their sequence when applicable. An additional chemotherapy drug given by IV push may be reported with 96411. For Medicare, this is an incident-to service and is 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 Washington, DC area compares for 96409

Across 109 of 109 payment localities, the office rate for 96409 runs from $90.24 in Arkansas to $146.28 in San Benito County, CA. Washington, DC area pays $122.03. The RVUs are the same everywhere; the geographic indexes change the dollars.

96409 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$122.03
  2. Los Angeles, CA · California$121.50−$0.53
  3. Miami, FL · Florida$111.48−$10.55
  4. Chicago, IL · Illinois$107.67−$14.36
  5. Manhattan, NY · New York$121.55−$0.48
  6. Alaska · Alaska$113.80−$8.23
  7. Alabama · Alabama$91.86−$30.17

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

Every other payment area

96409 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$90.24—
ArizonaArizona$101.33—
Bakersfield, CACalifornia$112.99—
Chico, CACalifornia$112.83—
El Centro, CACalifornia$112.84—
Fresno, CACalifornia$112.83—
Hanford, CACalifornia$112.83—
Madera, CACalifornia$112.83—

96409 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.

$90.24

$129.56

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

View every state and territory as a table
96409 office rate range by state
State / territoryOffice rate rangeLocalities
AK$113.801
AL$91.861
AR$90.241
AZ$101.331
CA$112.83–$146.2829
CO$110.251
CT$112.401
DC$122.031
DE$103.251
FL$101.39–$111.483
GA$94.72–$106.482
GU$116.651
HI$116.651
IA$95.301
ID$95.931
IL$97.45–$108.704
IN$96.611
KS$94.481
KY$93.881
LA$93.59–$99.242
MA$109.28–$122.992
MD$105.59–$122.033
ME$96.23–$102.952
MI$96.58–$102.612
MN$105.881
MO$91.45–$100.013
MS$90.881
MT$104.541
NC$97.491
ND$103.351
NE$96.021
NH$108.171
NJ$113.76–$120.312
NM$97.101
NV$104.301
NY$99.22–$124.645
OH$96.341
OK$93.981
OR$103.57–$114.652
PA$96.68–$108.952
PR$105.551
RI$107.601
SC$97.061
SD$103.211
TN$95.021
TX$95.90–$109.818
UT$98.671
VA$102.35–$122.032
VI$105.551
VT$102.611
WA$109.18–$126.042
WI$99.191
WV$93.031
WY$104.021

See 96409 in every payment locality

How the 96409 rate is calculated

Each of 96409’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 · 96409

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.24

0.24 RVUs× 1.000 GPCI

Practice expense2.83

2.83 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

3.1300

Conversion factor

$33.4009

Medicare rate

$104.54

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

12,799

Code
96409
Physician work
0.24
Practice expense
2.83
Malpractice
0.06

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 96409 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.24× 1.0540.2530
Practice expense2.83× 1.1783.3337
Malpractice0.06× 1.1130.0668
Total RVUs3.6535
Conversion factor× 33.4009

Office rate, Washington, DC area$122.03

Office: (0.24 × 1.054 + 2.83 × 1.178 + 0.06 × 1.113) × $33.4009 = $122.03

Open 96409 in the RVU calculator

Payment rules and modifiers for 96409

The CMS indicators that decide how 96409 is paid alongside other services.

CMS payment indicators · 96409

Chemotherapy push, single or initial drug

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.

How 96409 has changed in Washington, DC area

96409 · Office / nonfacility

$122.03

Effective 2026-10-01

The base rate is $12.84 higher than on 2025-10-01, moving from $109.19 to $122.03 (11.8%).

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

    $109.19changed to$122.03

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.57 changed to 2.83
    • Malpractice RVU 0.05 changed to 0.06
    • 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

    $117.91changed to$109.19

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.70 changed to 2.57
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $115.99changed to$117.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $122.58changed to$115.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.71 changed to 2.70
    • 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

    $132.10changed to$122.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.80 changed to 2.71
    • Malpractice RVU 0.08 changed to 0.06
    • 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

    $138.76changed to$132.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.95 changed to 2.80
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $133.07changed to$138.76

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.73 changed to 2.95
    • Malpractice RVU 0.08 changed to 0.06
    • 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

    $131.21changed to$133.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.74 changed to 2.73
    • Malpractice RVU 0.07 changed to 0.08
    • 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

    $133.24changed to$131.21

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.79 changed to 2.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $134.17changed to$133.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.82 changed to 2.79
    • 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

    $133.47changed to$134.17

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.81 changed to 2.82
    • 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

    $133.50changed to$133.47

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $132.83changed to$133.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $129.60changed to$132.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.75 changed to 2.81
    • Malpractice RVU 0.05 changed to 0.06
    • 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

    $132.77changed to$129.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.00 changed to 2.75
    • 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: $132.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$122.03Not available in this settingRVU26D
2026-07-01$122.03Not available in this settingRVU26C
2026-04-01$122.03Not available in this settingRVU26B
2026-01-01$122.03Not available in this settingRVU26A
2025-10-01$109.19Not available in this settingRVU25D
2025-07-01$109.19Not available in this settingRVU25C
2025-04-01$109.19Not available in this settingRVU25B
2025-01-01$109.19Not available in this settingRVU25A
2024-10-01$117.91Not available in this settingRVU24D
2024-07-01$117.91Not available in this settingRVU24C
2024-04-01$117.91Not available in this settingRVU24B
2024-03-09$117.91Not available in this settingRVU24AR
2024-01-01$115.99Not available in this settingRVU24A
2023-10-01$122.58Not available in this settingRVU23D
2023-07-01$122.58Not available in this settingRVU23C
2023-04-01$122.58Not available in this settingRVU23B
2023-01-01$122.58Not available in this settingRVU23A
2022-10-01$132.10Not available in this settingRVU22D
2022-07-01$132.10Not available in this settingRVU22C
2022-04-01$132.10Not available in this settingRVU22B
2022-01-01$132.10Not available in this settingRVU22A
2021-10-01$138.76Not available in this settingRVU21D
2021-07-01$138.76Not available in this settingRVU21C
2021-04-01$138.76Not available in this settingRVU21B
2021-01-01$138.76Not available in this settingRVU21A
2020-10-01$133.07Not available in this settingRVU20D
2020-07-01$133.07Not available in this settingRVU20C
2020-04-01$133.07Not available in this settingRVU20B
2020-01-01$133.07Not available in this settingRVU20A
2019-10-01$131.21Not available in this settingRVU19D
2019-07-01$131.21Not available in this settingRVU19C
2019-04-01$131.21Not available in this settingRVU19B
2019-01-01$131.21Not available in this settingRVU19A
2018-10-01$133.24Not available in this settingRVU18D
2018-07-01$133.24Not available in this settingRVU18C
2018-04-01$133.24Not available in this settingRVU18B
2018-01-01$133.24Not available in this settingRVU18AR1
2017-10-01$134.17Not available in this settingRVU17D
2017-07-01$134.17Not available in this settingRVU17C
2017-04-01$134.17Not available in this settingRVU17B
2017-01-01$134.17Not available in this settingRVU17A
2016-10-01$133.47Not available in this settingRVU16D
2016-07-01$133.47Not available in this settingRVU16C
2016-04-01$133.47Not available in this settingRVU16B
2016-01-01$133.47Not available in this settingRVU16A
2015-10-01$133.50Not available in this settingRVU15D
2015-07-01$133.50Not available in this settingRVU15C
2015-04-01$132.83Not available in this settingRVU15B
2015-01-01$132.83Not available in this settingRVU15A
2014-10-01$129.60Not available in this settingRVU14D
2014-07-01$129.60Not available in this settingRVU14C
2014-04-01$129.60Not available in this settingRVU14B
2014-01-01$129.60Not available in this settingRVU14A
2013-10-01$132.77Not available in this settingRVU13D
2013-07-01$132.77Not available in this settingRVU13C
2013-04-01$132.77Not available in this settingRVU13B
2013-01-01$132.77Not available in this settingRVU13AR

Price 96409 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

96409 billing questions

When should 96409 be used instead of 96411?

Use 96409 for the single or initial chemotherapy drug given by IV push. Report 96411 for an additional chemotherapy drug administered by IV push in the same treatment.

How does 96409 differ from 96413?

96409 describes a brief IV push. Use 96413 when the chemotherapy is administered by IV infusion over time, rather than by push.

Is the chemotherapy drug included in 96409?

The code represents the administration service, not the drug supply. Report the drug separately when it is separately payable and the record supports it.

What documentation supports 96409?

The medication administration record should identify the antineoplastic drug, dose, IV route, and push method. Record any additional drugs and their sequence to support use of 96411 when applicable.

What Medicare supervision condition applies?

Medicare treats 96409 as an incident-to service. It may be 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 96409PPRRVU2026_Oct_nonQPP.csv, line 12,799 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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