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

In Queens, NY, Medicare pays $32.98 for 96415 in the office.

Check a contract rate as a % of Medicare · 96415 nationwide

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.

How Queens, NY compares for 96415

Across 109 of 109 payment localities, the office rate for 96415 runs from $25.05 in Arkansas to $38.23 in San Benito County, CA. Queens, NY pays $32.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96415 rates by state

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

See 96415 in every payment locality

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.

Codes related to 96415

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

How 96415 has changed in Queens, NY

Price 96415 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

• 96415 in New York · multiple payment areas

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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