CPT code 96409: Chemotherapy push, single or initial drug2026 Medicare rate & RVUs in Detroit, MI

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 Detroit, MI, Medicare pays $102.61 for 96409 in the office.

$102.61Office (non-facility)
Not available in this settingHospital or facility
−1.8%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 Detroit, MI
  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 Detroit, MI 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. Detroit, MI pays $102.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

96409 in Detroit, MI vs other payment areas
  1. Detroit, MI · this page$102.61
  2. Rest of Michigan · Michigan$96.58−$6.03
  3. Los Angeles, CA · California$121.50+$18.89
  4. Washington, DC area · District of Columbia$122.03+$19.42
  5. Miami, FL · Florida$111.48+$8.87
  6. Chicago, IL · Illinois$107.67+$5.06
  7. Manhattan, NY · New York$121.55+$18.94

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

Every other payment area

96409 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$113.80—
AlabamaAlabama$91.86—
ArkansasArkansas$90.24—
ArizonaArizona$101.33—
Bakersfield, CACalifornia$112.99—
Chico, CACalifornia$112.83—
El Centro, CACalifornia$112.84—
Fresno, 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 Detroit, MI 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

64

Locality
Detroit, MI
Physician work
1.000
Practice expense
0.965
Malpractice
1.686
Office calculation for 96409 in Detroit, MI
ComponentRVULocality factorAdjusted
Physician work0.24× 1.0000.2400
Practice expense2.83× 0.9652.7309
Malpractice0.06× 1.6860.1012
Total RVUs3.0721
Conversion factor× 33.4009

Office rate, Detroit, MI$102.61

Office: (0.24 × 1 + 2.83 × 0.965 + 0.06 × 1.686) × $33.4009 = $102.61

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 Detroit, MI

96409 · Office / nonfacility

$102.61

Effective 2026-10-01

The base rate is $10.08 higher than on 2025-10-01, moving from $92.53 to $102.61 (10.9%).

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

    $92.53changed to$102.61

    • 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 1.003 changed to 1.000
    • Practice expense GPCI 0.986 changed to 0.965
    • Malpractice GPCI 1.718 changed to 1.686

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $100.06changed to$92.53

    • 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

    $98.43changed to$100.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $102.63changed to$98.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.71 changed to 2.70
    • Work GPCI 1.000 changed to 1.003
    • Practice expense GPCI 0.992 changed to 0.986
    • Malpractice GPCI 1.670 changed to 1.718
  5. January 1, 2023

    RVU23A

    $109.40changed to$102.63

    • 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
    • Practice expense GPCI 0.997 changed to 0.992
    • Malpractice GPCI 1.622 changed to 1.670

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $114.40changed to$109.40

    • 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

    $111.28changed to$114.40

    • 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
    • Practice expense GPCI 0.993 changed to 0.997
    • Malpractice GPCI 1.657 changed to 1.622

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $110.58changed to$111.28

    • 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
    • Practice expense GPCI 0.989 changed to 0.993
    • Malpractice GPCI 1.691 changed to 1.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $112.24changed to$110.58

    • 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

    $112.80changed to$112.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.82 changed to 2.79
    • Practice expense GPCI 0.992 changed to 0.989
    • Malpractice GPCI 1.510 changed to 1.691

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $111.93changed to$112.80

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.81 changed to 2.82
    • Practice expense GPCI 0.994 changed to 0.992
    • Malpractice GPCI 1.328 changed to 1.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $111.85changed to$111.93

    • 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

    $111.30changed to$111.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $110.90changed to$111.30

    • 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 1.010 changed to 1.000
    • Practice expense GPCI 1.009 changed to 0.994
    • Malpractice GPCI 1.571 changed to 1.328

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $115.85changed to$110.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.00 changed to 2.75
    • Work GPCI 1.022 changed to 1.010
    • Practice expense GPCI 1.023 changed to 1.009
    • Malpractice GPCI 1.814 changed to 1.571

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $115.85

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$102.61Not available in this settingRVU26D
2026-07-01$102.61Not available in this settingRVU26C
2026-04-01$102.61Not available in this settingRVU26B
2026-01-01$102.61Not available in this settingRVU26A
2025-10-01$92.53Not available in this settingRVU25D
2025-07-01$92.53Not available in this settingRVU25C
2025-04-01$92.53Not available in this settingRVU25B
2025-01-01$92.53Not available in this settingRVU25A
2024-10-01$100.06Not available in this settingRVU24D
2024-07-01$100.06Not available in this settingRVU24C
2024-04-01$100.06Not available in this settingRVU24B
2024-03-09$100.06Not available in this settingRVU24AR
2024-01-01$98.43Not available in this settingRVU24A
2023-10-01$102.63Not available in this settingRVU23D
2023-07-01$102.63Not available in this settingRVU23C
2023-04-01$102.63Not available in this settingRVU23B
2023-01-01$102.63Not available in this settingRVU23A
2022-10-01$109.40Not available in this settingRVU22D
2022-07-01$109.40Not available in this settingRVU22C
2022-04-01$109.40Not available in this settingRVU22B
2022-01-01$109.40Not available in this settingRVU22A
2021-10-01$114.40Not available in this settingRVU21D
2021-07-01$114.40Not available in this settingRVU21C
2021-04-01$114.40Not available in this settingRVU21B
2021-01-01$114.40Not available in this settingRVU21A
2020-10-01$111.28Not available in this settingRVU20D
2020-07-01$111.28Not available in this settingRVU20C
2020-04-01$111.28Not available in this settingRVU20B
2020-01-01$111.28Not available in this settingRVU20A
2019-10-01$110.58Not available in this settingRVU19D
2019-07-01$110.58Not available in this settingRVU19C
2019-04-01$110.58Not available in this settingRVU19B
2019-01-01$110.58Not available in this settingRVU19A
2018-10-01$112.24Not available in this settingRVU18D
2018-07-01$112.24Not available in this settingRVU18C
2018-04-01$112.24Not available in this settingRVU18B
2018-01-01$112.24Not available in this settingRVU18AR1
2017-10-01$112.80Not available in this settingRVU17D
2017-07-01$112.80Not available in this settingRVU17C
2017-04-01$112.80Not available in this settingRVU17B
2017-01-01$112.80Not available in this settingRVU17A
2016-10-01$111.93Not available in this settingRVU16D
2016-07-01$111.93Not available in this settingRVU16C
2016-04-01$111.93Not available in this settingRVU16B
2016-01-01$111.93Not available in this settingRVU16A
2015-10-01$111.85Not available in this settingRVU15D
2015-07-01$111.85Not available in this settingRVU15C
2015-04-01$111.30Not available in this settingRVU15B
2015-01-01$111.30Not available in this settingRVU15A
2014-10-01$110.90Not available in this settingRVU14D
2014-07-01$110.90Not available in this settingRVU14C
2014-04-01$110.90Not available in this settingRVU14B
2014-01-01$110.90Not available in this settingRVU14A
2013-10-01$115.85Not available in this settingRVU13D
2013-07-01$115.85Not available in this settingRVU13C
2013-04-01$115.85Not available in this settingRVU13B
2013-01-01$115.85Not available in this settingRVU13AR

Price 96409 for an earlier date of service

Where the Detroit, MI rate applies

Detroit, MI is a Medicare payment area, not a city. Our Census mapping connects it to 98 cities and communities in Michigan. Some span more than one payment area; confirm with the service ZIP.

  • Detroit
  • Allen Park
  • Ann Arbor
  • Armada
  • Auburn Hills
  • Barton Hills
  • Belleville
  • Berkley

Browse all communities in Michigan

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 Detroit, MIGPCI2026.csv, line 64 (RVU26D)

Open CMS sourceHow we calculate rates

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