CPT code 96413: Chemo IV infusion, initial drug, first hour2026 Medicare rate & RVUs in Alaska

Report the initial hour of intravenous antineoplastic or qualifying highly complex biologic infusion when the drug runs longer than 15 minutes.

CMS RVU26DEffective Oct 1, 2026One payment locality1.7M Medicare services in 2024

In Alaska, Medicare pays $144.80 for 96413 in the office.

$144.80Office (non-facility)
Not available in this settingHospital or facility
+8.7%vs the national office rate ($133.27)

Check a contract rate as a % of Medicare · 96413 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 96413 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alaska
  2. What 96413 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 96413 covers

Code 96413 captures the initial hour of an intravenous antineoplastic infusion or an infusion of another agent that meets chemotherapy administration requirements for high-complexity biologic therapy. Oncology nurses commonly administer these treatments in physician offices or outpatient infusion suites under an oncologist’s or hematologist’s supervision. Paclitaxel or carboplatin infusions are familiar examples. Nursing work includes preparing the infusion, assessing the patient, monitoring for reactions, and ending the infusion; classification as a monoclonal antibody alone does not establish eligibility for chemotherapy administration coding.

Report one initial administration service per encounter unless separate medically necessary IV sites support distinct initial services. Record the drug and actual start and stop times; infusion lasting more than 15 minutes supports 96413, and 96415 begins only when the infusion exceeds 90 minutes. Sequential chemotherapy drugs and separately administered premedications or hydration may support additional administration codes when their requirements are met. The IV start, routine flush, and usual supplies are included; report separately payable drug products with appropriate HCPCS codes. CMS classifies 96413 as an incident-to service, 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 Alaska compares for 96413

Across 109 of 109 payment localities, the office rate for 96413 runs from $114.99 in Arkansas to $186.95 in San Benito County, CA. Alaska pays $144.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

96413 in Alaska vs other payment areas
  1. Alaska · this page$144.80
  2. Los Angeles, CA · California$155.12+$10.32
  3. Washington, DC area · District of Columbia$155.68+$10.88
  4. Miami, FL · Florida$141.83−$2.97
  5. Chicago, IL · Illinois$136.97−$7.83
  6. Manhattan, NY · New York$154.93+$10.13
  7. Alabama · Alabama$117.06−$27.74

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

Every other payment area

96413 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$114.99—
ArizonaArizona$129.16—
Bakersfield, CACalifornia$144.20—
Chico, CACalifornia$144.02—
El Centro, CACalifornia$144.03—
Fresno, CACalifornia$144.02—
Hanford, CACalifornia$144.02—
Madera, CACalifornia$144.02—

96413 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.

$114.99

$165.49

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

View every state and territory as a table
96413 office rate range by state
State / territoryOffice rate rangeLocalities
AK$144.801
AL$117.061
AR$114.991
AZ$129.161
CA$144.02–$186.9529
CO$140.651
CT$143.311
DC$155.681
DE$131.621
FL$129.10–$141.833
GA$120.59–$135.712
GU$148.941
HI$148.941
IA$121.531
ID$122.311
IL$124.01–$138.424
IN$123.191
KS$120.441
KY$119.581
LA$119.19–$126.412
MA$139.39–$156.982
MD$134.63–$155.683
ME$122.66–$131.312
MI$122.99–$130.622
MN$135.151
MO$116.43–$127.443
MS$115.761
MT$133.261
NC$124.281
ND$131.881
NE$122.451
NH$137.961
NJ$145.06–$153.472
NM$123.651
NV$133.001
NY$126.50–$158.855
OH$122.711
OK$119.741
OR$132.09–$146.322
PA$123.17–$138.872
PR$134.571
RI$137.211
SC$123.681
SD$131.721
TN$121.121
TX$122.16–$140.078
UT$125.741
VA$130.52–$155.682
VI$134.571
VT$130.901
WA$139.28–$160.912
WI$126.551
WV$118.351
WY$132.661

See 96413 in every payment locality

How the 96413 rate is calculated

Each of 96413’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 · 96413

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.28

0.28 RVUs× 1.000 GPCI

Practice expense3.64

3.64 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.9900

Conversion factor

$33.4009

Medicare rate

$133.27

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

The exact Alaska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,801

Code
96413
Physician work
0.28
Practice expense
3.64
Malpractice
0.07

GPCI2026.csv

5

Locality
Alaska
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Office calculation for 96413 in Alaska
ComponentRVULocality factorAdjusted
Physician work0.28× 1.5000.4200
Practice expense3.64× 1.0653.8766
Malpractice0.07× 0.5510.0386
Total RVUs4.3352
Conversion factor× 33.4009

Office rate, Alaska$144.80

Office: (0.28 × 1.5 + 3.64 × 1.065 + 0.07 × 0.551) × $33.4009 = $144.80

Open 96413 in the RVU calculator

Payment rules and modifiers for 96413

The CMS indicators that decide how 96413 is paid alongside other services.

CMS payment indicators · 96413

Chemo IV infusion, initial drug, first hour

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 96413 has changed in Alaska

96413 · Office / nonfacility

$144.80

Effective 2026-10-01

The base rate is $12.93 higher than on 2025-10-01, moving from $131.87 to $144.80 (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

    $131.87changed to$144.80

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.35 changed to 3.64
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 1.081 changed to 1.065
    • Malpractice GPCI 0.592 changed to 0.551

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $142.38changed to$131.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.53 changed to 3.35
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $140.06changed to$142.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $147.99changed to$140.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.55 changed to 3.53
    • Practice expense GPCI 1.100 changed to 1.081
    • Malpractice GPCI 0.603 changed to 0.592
  5. January 1, 2023

    RVU23A

    $158.83changed to$147.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.68 changed to 3.55
    • Malpractice RVU 0.09 changed to 0.07
    • Practice expense GPCI 1.118 changed to 1.100
    • Malpractice GPCI 0.614 changed to 0.603

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $167.94changed to$158.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.88 changed to 3.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $161.75changed to$167.94

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.58 changed to 3.88
    • Malpractice GPCI 0.661 changed to 0.614

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $162.50changed to$161.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.61 changed to 3.58
    • Malpractice RVU 0.08 changed to 0.09
    • Practice expense GPCI 1.117 changed to 1.118
    • Malpractice GPCI 0.708 changed to 0.661

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $164.33changed to$162.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.66 changed to 3.61

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $157.99changed to$164.33

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.53 changed to 3.66
    • Practice expense GPCI 1.112 changed to 1.117
    • Malpractice GPCI 0.710 changed to 0.708

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $153.82changed to$157.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.45 changed to 3.53
    • Practice expense GPCI 1.107 changed to 1.112
    • Malpractice GPCI 0.712 changed to 0.710

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $154.12changed to$153.82

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $153.35changed to$154.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $148.28changed to$153.35

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.39 changed to 3.45
    • Malpractice RVU 0.05 changed to 0.07
    • Practice expense GPCI 1.087 changed to 1.107
    • Malpractice GPCI 0.687 changed to 0.712

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $156.27changed to$148.28

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.88 changed to 3.39
    • Practice expense GPCI 1.067 changed to 1.087
    • Malpractice GPCI 0.661 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $156.27

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$144.80Not available in this settingRVU26D
2026-07-01$144.80Not available in this settingRVU26C
2026-04-01$144.80Not available in this settingRVU26B
2026-01-01$144.80Not available in this settingRVU26A
2025-10-01$131.87Not available in this settingRVU25D
2025-07-01$131.87Not available in this settingRVU25C
2025-04-01$131.87Not available in this settingRVU25B
2025-01-01$131.87Not available in this settingRVU25A
2024-10-01$142.38Not available in this settingRVU24D
2024-07-01$142.38Not available in this settingRVU24C
2024-04-01$142.38Not available in this settingRVU24B
2024-03-09$142.38Not available in this settingRVU24AR
2024-01-01$140.06Not available in this settingRVU24A
2023-10-01$147.99Not available in this settingRVU23D
2023-07-01$147.99Not available in this settingRVU23C
2023-04-01$147.99Not available in this settingRVU23B
2023-01-01$147.99Not available in this settingRVU23A
2022-10-01$158.83Not available in this settingRVU22D
2022-07-01$158.83Not available in this settingRVU22C
2022-04-01$158.83Not available in this settingRVU22B
2022-01-01$158.83Not available in this settingRVU22A
2021-10-01$167.94Not available in this settingRVU21D
2021-07-01$167.94Not available in this settingRVU21C
2021-04-01$167.94Not available in this settingRVU21B
2021-01-01$167.94Not available in this settingRVU21A
2020-10-01$161.75Not available in this settingRVU20D
2020-07-01$161.75Not available in this settingRVU20C
2020-04-01$161.75Not available in this settingRVU20B
2020-01-01$161.75Not available in this settingRVU20A
2019-10-01$162.50Not available in this settingRVU19D
2019-07-01$162.50Not available in this settingRVU19C
2019-04-01$162.50Not available in this settingRVU19B
2019-01-01$162.50Not available in this settingRVU19A
2018-10-01$164.33Not available in this settingRVU18D
2018-07-01$164.33Not available in this settingRVU18C
2018-04-01$164.33Not available in this settingRVU18B
2018-01-01$164.33Not available in this settingRVU18AR1
2017-10-01$157.99Not available in this settingRVU17D
2017-07-01$157.99Not available in this settingRVU17C
2017-04-01$157.99Not available in this settingRVU17B
2017-01-01$157.99Not available in this settingRVU17A
2016-10-01$153.82Not available in this settingRVU16D
2016-07-01$153.82Not available in this settingRVU16C
2016-04-01$153.82Not available in this settingRVU16B
2016-01-01$153.82Not available in this settingRVU16A
2015-10-01$154.12Not available in this settingRVU15D
2015-07-01$154.12Not available in this settingRVU15C
2015-04-01$153.35Not available in this settingRVU15B
2015-01-01$153.35Not available in this settingRVU15A
2014-10-01$148.28Not available in this settingRVU14D
2014-07-01$148.28Not available in this settingRVU14C
2014-04-01$148.28Not available in this settingRVU14B
2014-01-01$148.28Not available in this settingRVU14A
2013-10-01$156.27Not available in this settingRVU13D
2013-07-01$156.27Not available in this settingRVU13C
2013-04-01$156.27Not available in this settingRVU13B
2013-01-01$156.27Not available in this settingRVU13AR

Price 96413 for an earlier date of service

Where the Alaska rate applies

Alaska is a Medicare payment area, not a city. Our Census mapping connects it to 355 cities and communities in Alaska. Some span more than one payment area; confirm with the service ZIP.

  • Adak
  • Akhiok
  • Akiachak
  • Akiak
  • Akutan
  • Alakanuk
  • Alatna
  • Alcan Border

Browse all communities in Alaska

96413 billing questions

How long must the infusion run to report 96413 instead of a push code?

The infusion must last more than 15 minutes. If the drug runs for 15 minutes or less, report 96409 for an antineoplastic IV push.

When is 96415 added for extra time?

Add 96415 for each additional hour of the same infusion once the infusion exceeds 90 minutes. An infusion lasting exactly 90 minutes supports 96413 alone.

Can 96413 be billed more than once on the same day?

Report one initial administration service per encounter unless separate medically necessary IV sites support distinct initial services. Append modifier 59 or, when accepted, XS to the distinct service and document the separate sites.

How are antiemetic premedications and hydration reported with chemotherapy?

A separately administered antiemetic may support 96375 for an IV push or 96367 for a sequential infusion. Medically necessary hydration may support 96361 when its time is separately documented, exceeds 30 minutes, and is not concurrent with the drug infusion.

Is a same-day E/M visit separately billable with 96413?

Yes, when the clinician performs a significant, separately identifiable evaluation beyond the routine pre-infusion assessment; append modifier 25 to the E/M code. Routine nursing checks and vital signs are part of the administration service.

Does 96413 include the chemotherapy drug itself?

No. Report a separately payable drug with its appropriate HCPCS code, often a J code, using units based on the administered dose and documenting any reportable waste.

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 96413PPRRVU2026_Oct_nonQPP.csv, line 12,801 (RVU26D)
Geographic factors for AlaskaGPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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