CPT code 96416: Pump infusion, prolonged infusion over eight hours2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $131.72 for 96416 in the office.

Check a contract rate as a % of Medicare · 96416 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 96416 covers

This service covers starting an intravenous chemotherapy infusion intended to continue for more than eight hours using a portable or implantable pump. It is commonly initiated by oncology staff in an office infusion clinic, with the patient continuing the infusion outside the clinic. The pump may be portable or implanted; the defining features are the prolonged infusion and pump-based delivery.

Report 96416 for starting the qualifying infusion, not for each hour the pump continues to deliver medication. Documentation should identify the chemotherapy drug, intravenous route, pump use, and infusion duration, and support that the service was initiated. The chemotherapy drug is reported separately when applicable. CMS treats this as an incident-to service: it may be 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 South Dakota compares for 96416

Across 109 of 109 payment localities, the office rate for 96416 runs from $114.66 in Arkansas to $187.73 in San Benito County, CA. South Dakota pays $131.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

96416 rates by state

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

See 96416 in every payment locality

How the 96416 rate is calculated

Each of 96416’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 96416

The CMS indicators that decide how 96416 is paid alongside other services.

Codes related to 96416

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

How 96416 has changed in South Dakota

Price 96416 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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