CPT code 96409: Chemotherapy push, single or initial drug2026 Medicare rate & RVUs in Virginia
Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug.
In Virginia, Medicare pays $102.35 for 96409 in the office.
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.
On this page 11 sections
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 Virginia 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. Virginia pays $102.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$102.35
- Los Angeles, CA · California$121.50+$19.15
- Washington, DC area · District of Columbia$122.03+$19.68
- Miami, FL · Florida$111.48+$9.13
- Chicago, IL · Illinois$107.67+$5.32
- Manhattan, NY · New York$121.55+$19.20
- Alaska · Alaska$113.80+$11.45
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Hanford, CACalifornia | $112.83 | — |
| Madera, CACalifornia | $112.83 | — |
| Merced, CACalifornia | $112.83 | — |
| Modesto, CACalifornia | $112.83 | — |
| Napa, CACalifornia | $134.12 | — |
| Oxnard, CACalifornia | $121.22 | — |
| Redding, CACalifornia | $112.83 | — |
| Rest of CaliforniaCalifornia | $112.83 | — |
| Riverside, CACalifornia | $113.47 | — |
| Sacramento, CACalifornia | $119.31 | — |
| Salinas, CACalifornia | $118.89 | — |
| San Diego, CACalifornia | $122.39 | — |
| Marin County, CACalifornia | $142.98 | — |
| San Francisco, CACalifornia | $142.91 | — |
| San Benito County, CACalifornia | $146.28 | — |
| Santa Clara County, CACalifornia | $146.00 | — |
| San Luis Obispo, CACalifornia | $116.89 | — |
| Santa Cruz, CACalifornia | $124.11 | — |
| Santa Maria, CACalifornia | $119.53 | — |
| Santa Rosa, CACalifornia | $125.41 | — |
| Stockton, CACalifornia | $112.83 | — |
| Vallejo, CACalifornia | $134.02 | — |
| Visalia, CACalifornia | $112.83 | — |
| Yuba City, CACalifornia | $112.83 | — |
| ColoradoColorado | $110.25 | — |
| ConnecticutConnecticut | $112.40 | — |
| DelawareDelaware | $103.25 | — |
| Fort Lauderdale, FLFlorida | $107.39 | — |
| Rest of FloridaFlorida | $101.39 | — |
| Atlanta, GAGeorgia | $106.48 | — |
| Rest of GeorgiaGeorgia | $94.72 | — |
| Hawaii, Guam, HIHawaii | $116.65 | — |
| IowaIowa | $95.30 | — |
| IdahoIdaho | $95.93 | — |
| East St. Louis, ILIllinois | $99.01 | — |
| Rest of IllinoisIllinois | $97.45 | — |
| Suburban Chicago, ILIllinois | $108.70 | — |
| IndianaIndiana | $96.61 | — |
| KansasKansas | $94.48 | — |
| KentuckyKentucky | $93.88 | — |
| New Orleans, LALouisiana | $99.24 | — |
| Rest of LouisianaLouisiana | $93.59 | — |
| Metropolitan Boston, MAMassachusetts | $122.99 | — |
| Rest of MassachusettsMassachusetts | $109.28 | — |
| Baltimore area, MDMaryland | $112.05 | — |
| Rest of MarylandMaryland | $105.59 | — |
| Rest of MaineMaine | $96.23 | — |
| Southern Maine, MEMaine | $102.95 | — |
| Detroit, MIMichigan | $102.61 | — |
| Rest of MichiganMichigan | $96.58 | — |
| MinnesotaMinnesota | $105.88 | — |
| Metropolitan Kansas City, MOMissouri | $98.73 | — |
| Metropolitan St. Louis, MOMissouri | $100.01 | — |
| Rest of MissouriMissouri | $91.45 | — |
| MississippiMississippi | $90.88 | — |
| MontanaMontana | $104.54 | — |
| North CarolinaNorth Carolina | $97.49 | — |
| North DakotaNorth Dakota | $103.35 | — |
| NebraskaNebraska | $96.02 | — |
| New HampshireNew Hampshire | $108.17 | — |
| Northern New JerseyNew Jersey | $120.31 | — |
| Rest of New JerseyNew Jersey | $113.76 | — |
| New MexicoNew Mexico | $97.10 | — |
| NevadaNevada | $104.30 | — |
| NYC suburbs and Long Island, NYNew York | $124.64 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $114.31 | — |
| Queens, NYNew York | $123.15 | — |
| Rest of New YorkNew York | $99.22 | — |
| OhioOhio | $96.34 | — |
| OklahomaOklahoma | $93.98 | — |
| Portland, OROregon | $114.65 | — |
| Rest of OregonOregon | $103.57 | — |
| Metropolitan Philadelphia, PAPennsylvania | $108.95 | — |
| Rest of PennsylvaniaPennsylvania | $96.68 | — |
| Puerto RicoPuerto Rico | $105.55 | — |
| Rhode IslandRhode Island | $107.60 | — |
| South CarolinaSouth Carolina | $97.06 | — |
| South DakotaSouth Dakota | $103.21 | — |
| TennesseeTennessee | $95.02 | — |
| Austin, TXTexas | $109.81 | — |
| Beaumont, TXTexas | $95.90 | — |
| Brazoria, TXTexas | $103.32 | — |
| Dallas, TXTexas | $103.95 | — |
| Fort Worth, TXTexas | $103.04 | — |
| Galveston, TXTexas | $103.60 | — |
| Houston, TXTexas | $104.70 | — |
| Rest of TexasTexas | $99.53 | — |
| UtahUtah | $98.67 | — |
| Virgin Islands, VIUnited States Virgin Islands | $105.55 | — |
| VermontVermont | $102.61 | — |
| Rest of WashingtonWashington | $109.18 | — |
| King County, WAWashington | $126.04 | — |
| WisconsinWisconsin | $99.19 | — |
| West VirginiaWest Virginia | $93.03 | — |
| WyomingWyoming | $104.02 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $113.80 | 1 |
| AL | $91.86 | 1 |
| AR | $90.24 | 1 |
| AZ | $101.33 | 1 |
| CA | $112.83–$146.28 | 29 |
| CO | $110.25 | 1 |
| CT | $112.40 | 1 |
| DC | $122.03 | 1 |
| DE | $103.25 | 1 |
| FL | $101.39–$111.48 | 3 |
| GA | $94.72–$106.48 | 2 |
| GU | $116.65 | 1 |
| HI | $116.65 | 1 |
| IA | $95.30 | 1 |
| ID | $95.93 | 1 |
| IL | $97.45–$108.70 | 4 |
| IN | $96.61 | 1 |
| KS | $94.48 | 1 |
| KY | $93.88 | 1 |
| LA | $93.59–$99.24 | 2 |
| MA | $109.28–$122.99 | 2 |
| MD | $105.59–$122.03 | 3 |
| ME | $96.23–$102.95 | 2 |
| MI | $96.58–$102.61 | 2 |
| MN | $105.88 | 1 |
| MO | $91.45–$100.01 | 3 |
| MS | $90.88 | 1 |
| MT | $104.54 | 1 |
| NC | $97.49 | 1 |
| ND | $103.35 | 1 |
| NE | $96.02 | 1 |
| NH | $108.17 | 1 |
| NJ | $113.76–$120.31 | 2 |
| NM | $97.10 | 1 |
| NV | $104.30 | 1 |
| NY | $99.22–$124.64 | 5 |
| OH | $96.34 | 1 |
| OK | $93.98 | 1 |
| OR | $103.57–$114.65 | 2 |
| PA | $96.68–$108.95 | 2 |
| PR | $105.55 | 1 |
| RI | $107.60 | 1 |
| SC | $97.06 | 1 |
| SD | $103.21 | 1 |
| TN | $95.02 | 1 |
| TX | $95.90–$109.81 | 8 |
| UT | $98.67 | 1 |
| VA | $102.35–$122.03 | 2 |
| VI | $105.55 | 1 |
| VT | $102.61 | 1 |
| WA | $109.18–$126.04 | 2 |
| WI | $99.19 | 1 |
| WV | $93.03 | 1 |
| WY | $104.02 | 1 |
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
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 Virginia 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
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.24 | × 1.000 | 0.2400 |
| Practice expense | 2.83 | × 0.983 | 2.7819 |
| Malpractice | 0.06 | × 0.706 | 0.0424 |
| Total RVUs | 3.0642 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$102.35
Office: (0.24 × 1 + 2.83 × 0.983 + 0.06 × 0.706) × $33.4009 = $102.35
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
How 96409 has changed in Virginia
96409 · Office / nonfacility
$102.35
Effective 2026-10-01
The base rate is $11.55 higher than on 2025-10-01, moving from $90.80 to $102.35 (12.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$90.80changed to$102.35
- 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 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$97.95changed to$90.80
- 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.
March 9, 2024
RVU24AR
$96.35changed to$97.95
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$100.73changed to$96.35
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.71 changed to 2.70
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$107.20changed to$100.73
- 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 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$112.67changed to$107.20
- 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.
January 1, 2021
RVU21A
$108.91changed to$112.67
- 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 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$108.30changed to$108.91
- 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 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$109.96changed to$108.30
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.79 changed to 2.74
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$110.48changed to$109.96
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.82 changed to 2.79
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$109.56changed to$110.48
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.81 changed to 2.82
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$109.66changed to$109.56
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.06 changed to 0.07
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$109.11changed to$109.66
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$106.53changed to$109.11
- 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
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$109.13changed to$106.53
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.00 changed to 2.75
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $109.13
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $102.35 | Not available in this setting | RVU26D |
| 2026-07-01 | $102.35 | Not available in this setting | RVU26C |
| 2026-04-01 | $102.35 | Not available in this setting | RVU26B |
| 2026-01-01 | $102.35 | Not available in this setting | RVU26A |
| 2025-10-01 | $90.80 | Not available in this setting | RVU25D |
| 2025-07-01 | $90.80 | Not available in this setting | RVU25C |
| 2025-04-01 | $90.80 | Not available in this setting | RVU25B |
| 2025-01-01 | $90.80 | Not available in this setting | RVU25A |
| 2024-10-01 | $97.95 | Not available in this setting | RVU24D |
| 2024-07-01 | $97.95 | Not available in this setting | RVU24C |
| 2024-04-01 | $97.95 | Not available in this setting | RVU24B |
| 2024-03-09 | $97.95 | Not available in this setting | RVU24AR |
| 2024-01-01 | $96.35 | Not available in this setting | RVU24A |
| 2023-10-01 | $100.73 | Not available in this setting | RVU23D |
| 2023-07-01 | $100.73 | Not available in this setting | RVU23C |
| 2023-04-01 | $100.73 | Not available in this setting | RVU23B |
| 2023-01-01 | $100.73 | Not available in this setting | RVU23A |
| 2022-10-01 | $107.20 | Not available in this setting | RVU22D |
| 2022-07-01 | $107.20 | Not available in this setting | RVU22C |
| 2022-04-01 | $107.20 | Not available in this setting | RVU22B |
| 2022-01-01 | $107.20 | Not available in this setting | RVU22A |
| 2021-10-01 | $112.67 | Not available in this setting | RVU21D |
| 2021-07-01 | $112.67 | Not available in this setting | RVU21C |
| 2021-04-01 | $112.67 | Not available in this setting | RVU21B |
| 2021-01-01 | $112.67 | Not available in this setting | RVU21A |
| 2020-10-01 | $108.91 | Not available in this setting | RVU20D |
| 2020-07-01 | $108.91 | Not available in this setting | RVU20C |
| 2020-04-01 | $108.91 | Not available in this setting | RVU20B |
| 2020-01-01 | $108.91 | Not available in this setting | RVU20A |
| 2019-10-01 | $108.30 | Not available in this setting | RVU19D |
| 2019-07-01 | $108.30 | Not available in this setting | RVU19C |
| 2019-04-01 | $108.30 | Not available in this setting | RVU19B |
| 2019-01-01 | $108.30 | Not available in this setting | RVU19A |
| 2018-10-01 | $109.96 | Not available in this setting | RVU18D |
| 2018-07-01 | $109.96 | Not available in this setting | RVU18C |
| 2018-04-01 | $109.96 | Not available in this setting | RVU18B |
| 2018-01-01 | $109.96 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $110.48 | Not available in this setting | RVU17D |
| 2017-07-01 | $110.48 | Not available in this setting | RVU17C |
| 2017-04-01 | $110.48 | Not available in this setting | RVU17B |
| 2017-01-01 | $110.48 | Not available in this setting | RVU17A |
| 2016-10-01 | $109.56 | Not available in this setting | RVU16D |
| 2016-07-01 | $109.56 | Not available in this setting | RVU16C |
| 2016-04-01 | $109.56 | Not available in this setting | RVU16B |
| 2016-01-01 | $109.56 | Not available in this setting | RVU16A |
| 2015-10-01 | $109.66 | Not available in this setting | RVU15D |
| 2015-07-01 | $109.66 | Not available in this setting | RVU15C |
| 2015-04-01 | $109.11 | Not available in this setting | RVU15B |
| 2015-01-01 | $109.11 | Not available in this setting | RVU15A |
| 2014-10-01 | $106.53 | Not available in this setting | RVU14D |
| 2014-07-01 | $106.53 | Not available in this setting | RVU14C |
| 2014-04-01 | $106.53 | Not available in this setting | RVU14B |
| 2014-01-01 | $106.53 | Not available in this setting | RVU14A |
| 2013-10-01 | $109.13 | Not available in this setting | RVU13D |
| 2013-07-01 | $109.13 | Not available in this setting | RVU13C |
| 2013-04-01 | $109.13 | Not available in this setting | RVU13B |
| 2013-01-01 | $109.13 | Not available in this setting | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
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
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