CPT code 96415: Chemo infusion add-on, each additional hour2026 Medicare rate & RVUs

Medicare pays $28.39 for 96415 nationally in the office. Local office rates run $25.05–$38.23.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 96415 covers

This code captures continued infusion time when an intravenous chemotherapy, biologic response modifier, monoclonal antibody, or other highly complex drug infusion runs past its initial hour. Oncology and infusion nurses typically hang and monitor the infusion in physician offices and infusion suites, watching for hypersensitivity reactions, extravasation, and vital sign changes. Multi-hour monoclonal antibody infusions and slow-titrated first doses are common reasons for additional infusion time.

Report one unit for each qualifying additional hour after the initial hour reported with 96413 or a sequential hour reported with 96417. The first additional unit requires more than 30 minutes beyond that hour; for a single continuous infusion, total time must exceed 90 minutes. Record start and stop times for each infusion, the drug, route, and clinical monitoring. As an add-on, 96415 is billed with an eligible primary chemotherapy infusion service, normally 96413, and paid within that procedure’s global period. This incident-to service is billed only when performed under physician supervision. Report the drug separately with the appropriate HCPCS drug code and units when separately billable.

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.

Where 96415 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96415 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 96415 rate is calculated

Each of 96415’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.

Payment rules and modifiers for 96415

The CMS indicators that decide how 96415 is paid alongside other services.

96415 compared with similar codes

How to choose

96413Chemo IV infusionInitial drug, first hour

96413 covers the initial chemotherapy infusion, up to one hour, and is reported once; 96415 counts qualifying additional hours and cannot stand alone.

96417Chemotherapy infusionAdditional sequential drug

96417 covers an additional sequential infusion of a different drug, up to one hour; qualifying continued hours of that infusion use 96415.

96366IV infusion add-on hourTherapeutic or diagnostic, each additional hour

96366 covers qualifying additional hours of standard therapeutic, prophylactic, or diagnostic infusions, such as antibiotics; 96415 covers chemotherapy and other highly complex agents.

96416Pump infusionProlonged infusion over eight hours

96416 reports initiation of a pump-driven infusion lasting over eight hours, often continued away from the office; 96415 counts qualifying additional hours of a monitored infusion.

Codes related to 96415

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

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

Open CMS sourceHow we calculate rates