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CPT code 96423: Chemotherapy infusion, intra-arterial, each additional hour2026 Medicare rate & RVUs in Utah

Reports each additional qualifying hour of chemotherapy delivered by intra-arterial infusion after the initial infusion period represented by the primary service.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Utah, Medicare pays $71.23 for 96423 in the office.

$71.23Office (non-facility)
Not available in this settingHospital or facility
−5.6%vs the national office rate ($75.49)

Check a contract rate as a % of Medicare · 96423 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 96423 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 96423 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 96423 covers

This add-on service covers continued delivery of a chemotherapy agent through an artery after the initial intra-arterial infusion period. It is used in oncology care when treatment is administered through an arterial catheter rather than by intravenous infusion, injection, or a prolonged pump. Oncology clinicians and qualified staff may perform the administration in an outpatient or hospital setting, with the service furnished under physician supervision as an incident-to service.

Report 96423 with the primary intra-arterial infusion service, 96422; it is not a stand-alone administration code. Assign units from documented infusion duration and follow the applicable CPT time instructions. The record should identify the drug, route, infusion start and stop times, and the total time supporting the additional-hour unit or units. CMS classifies this as an add-on code paid within the primary procedure's global period, and permits billing 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 Utah compares for 96423

Across 109 of 109 payment localities, the office rate for 96423 runs from $65.07 in Arkansas to $105.45 in San Benito County, CA. Utah pays $71.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

96423 in Utah vs other payment areas
  1. Utah · this page$71.23
  2. Los Angeles, CA · California$87.63+$16.40
  3. Washington, DC area · District of Columbia$88.11+$16.88
  4. Miami, FL · Florida$80.83+$9.60
  5. Chicago, IL · Illinois$78.03+$6.80
  6. Manhattan, NY · New York$87.87+$16.64
  7. Alaska · Alaska$82.00+$10.77

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

Every other payment area

96423 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$66.24—
ArkansasArkansas$65.07—
ArizonaArizona$73.13—
Bakersfield, CACalifornia$81.48—
Chico, CACalifornia$81.35—
El Centro, CACalifornia$81.36—
Fresno, CACalifornia$81.35—
Hanford, CACalifornia$81.35—

96423 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$65.07

$93.40

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

View every state and territory as a table
96423 office rate range by state
State / territoryOffice rate rangeLocalities
AK$82.001
AL$66.241
AR$65.071
AZ$73.131
CA$81.35–$105.4529
CO$79.551
CT$81.201
DC$88.111
DE$74.531
FL$73.33–$80.833
GA$68.45–$76.932
GU$84.121
HI$84.121
IA$68.691
ID$69.151
IL$70.50–$78.654
IN$69.651
KS$68.121
KY$67.781
LA$67.58–$71.692
MA$78.85–$88.752
MD$76.22–$88.113
ME$69.40–$74.262
MI$69.77–$74.252
MN$76.291
MO$66.04–$72.223
MS$65.581
MT$75.481
NC$70.321
ND$74.491
NE$69.201
NH$78.071
NJ$82.14–$86.862
NM$70.171
NV$75.281
NY$71.58–$90.165
OH$69.571
OK$67.821
OR$74.72–$82.712
PA$69.81–$78.702
PR$76.211
RI$77.661
SC$70.061
SD$74.381
TN$68.511
TX$69.24–$79.268
UT$71.231
VA$73.84–$88.112
VI$76.211
VT$73.981
WA$78.77–$90.932
WI$71.471
WV$67.281
WY$75.051

See 96423 in every payment locality

How the 96423 rate is calculated

Each of 96423’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 · 96423

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.17

0.17 RVUs× 1.000 GPCI

Practice expense2.04

2.04 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.2600

Conversion factor

$33.4009

Medicare rate

$75.49

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,807

Code
96423
Physician work
0.17
Practice expense
2.04
Malpractice
0.05

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 96423 in Utah
ComponentRVULocality factorAdjusted
Physician work0.17× 1.0000.1700
Practice expense2.04× 0.9401.9176
Malpractice0.05× 0.8980.0449
Total RVUs2.1325
Conversion factor× 33.4009

Office rate, Utah$71.23

Office: (0.17 × 1 + 2.04 × 0.94 + 0.05 × 0.898) × $33.4009 = $71.23

Open 96423 in the RVU calculator

Payment rules and modifiers for 96423

The CMS indicators that decide how 96423 is paid alongside other services.

CMS payment indicators · 96423

Chemotherapy infusion, intra-arterial, each additional hour

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
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.

Codes related to 96423

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

Codes related to 96423
CodeHow it relatesOffice range, Utah
Primary code
96422Arterial infusion, up to one hourPrimary intra-arterial chemotherapy infusion service required with this additional-hour code.$132.11
Used instead
96415Chemo infusion add-on, each additional hourAdditional-hour chemotherapy infusion code for the intravenous route.$27.04
96420Chemotherapy push, intra-arterial routeIntra-arterial chemotherapy push, rather than continued infusion.$99.16
96413Chemo IV infusion, initial drug, first hourInitial-hour chemotherapy infusion code for the intravenous route.$125.74

How 96423 has changed in Utah

96423 · Office / nonfacility

$71.23

Effective 2026-10-01

The base rate is $8.39 higher than on 2025-10-01, moving from $62.84 to $71.23 (13.4%).

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

    $62.84changed to$71.23

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.86 changed to 2.04
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $68.08changed to$62.84

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.96 changed to 1.86
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $66.97changed to$68.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $68.75changed to$66.97

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.97 changed to 1.96
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $71.83changed to$68.75

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.03 changed to 1.97
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $76.27changed to$71.83

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.15 changed to 2.03

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $74.88changed to$76.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.00 changed to 2.15
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $75.71changed to$74.88

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.02 changed to 2.00
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $80.39changed to$75.71

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.15 changed to 2.02
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $71.27changed to$80.39

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.90 changed to 2.15
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $73.87changed to$71.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.99 changed to 1.90
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $74.47changed to$73.87

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.00 changed to 1.99

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $74.10changed to$74.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $71.91changed to$74.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.95 changed to 2.00
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $73.67changed to$71.91

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.13 changed to 1.95
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $73.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$71.23Not available in this settingRVU26D
2026-07-01$71.23Not available in this settingRVU26C
2026-04-01$71.23Not available in this settingRVU26B
2026-01-01$71.23Not available in this settingRVU26A
2025-10-01$62.84Not available in this settingRVU25D
2025-07-01$62.84Not available in this settingRVU25C
2025-04-01$62.84Not available in this settingRVU25B
2025-01-01$62.84Not available in this settingRVU25A
2024-10-01$68.08Not available in this settingRVU24D
2024-07-01$68.08Not available in this settingRVU24C
2024-04-01$68.08Not available in this settingRVU24B
2024-03-09$68.08Not available in this settingRVU24AR
2024-01-01$66.97Not available in this settingRVU24A
2023-10-01$68.75Not available in this settingRVU23D
2023-07-01$68.75Not available in this settingRVU23C
2023-04-01$68.75Not available in this settingRVU23B
2023-01-01$68.75Not available in this settingRVU23A
2022-10-01$71.83Not available in this settingRVU22D
2022-07-01$71.83Not available in this settingRVU22C
2022-04-01$71.83Not available in this settingRVU22B
2022-01-01$71.83Not available in this settingRVU22A
2021-10-01$76.27Not available in this settingRVU21D
2021-07-01$76.27Not available in this settingRVU21C
2021-04-01$76.27Not available in this settingRVU21B
2021-01-01$76.27Not available in this settingRVU21A
2020-10-01$74.88Not available in this settingRVU20D
2020-07-01$74.88Not available in this settingRVU20C
2020-04-01$74.88Not available in this settingRVU20B
2020-01-01$74.88Not available in this settingRVU20A
2019-10-01$75.71Not available in this settingRVU19D
2019-07-01$75.71Not available in this settingRVU19C
2019-04-01$75.71Not available in this settingRVU19B
2019-01-01$75.71Not available in this settingRVU19A
2018-10-01$80.39Not available in this settingRVU18D
2018-07-01$80.39Not available in this settingRVU18C
2018-04-01$80.39Not available in this settingRVU18B
2018-01-01$80.39Not available in this settingRVU18AR1
2017-10-01$71.27Not available in this settingRVU17D
2017-07-01$71.27Not available in this settingRVU17C
2017-04-01$71.27Not available in this settingRVU17B
2017-01-01$71.27Not available in this settingRVU17A
2016-10-01$73.87Not available in this settingRVU16D
2016-07-01$73.87Not available in this settingRVU16C
2016-04-01$73.87Not available in this settingRVU16B
2016-01-01$73.87Not available in this settingRVU16A
2015-10-01$74.47Not available in this settingRVU15D
2015-07-01$74.47Not available in this settingRVU15C
2015-04-01$74.10Not available in this settingRVU15B
2015-01-01$74.10Not available in this settingRVU15A
2014-10-01$71.91Not available in this settingRVU14D
2014-07-01$71.91Not available in this settingRVU14C
2014-04-01$71.91Not available in this settingRVU14B
2014-01-01$71.91Not available in this settingRVU14A
2013-10-01$73.67Not available in this settingRVU13D
2013-07-01$73.67Not available in this settingRVU13C
2013-04-01$73.67Not available in this settingRVU13B
2013-01-01$73.67Not available in this settingRVU13AR

Price 96423 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

96423 billing questions

When should 96423 be reported instead of 96415?

Use 96423 for additional qualifying time during an intra-arterial chemotherapy infusion. Code 96415 describes additional time for an intravenous chemotherapy infusion.

Can 96423 be billed by itself?

No. It is an add-on code reported with the primary intra-arterial infusion service, 96422.

What documentation supports the additional-hour units?

Document the chemotherapy agent, intra-arterial route, and infusion start and stop times. The recorded duration must support the units under the applicable CPT time instructions.

Does physician supervision affect reporting?

Yes. CMS identifies this as an incident-to service and allows billing only when it is performed under physician supervision.

Is 96423 used for an intra-arterial push?

No. It describes additional infusion time, not push administration. Code 96420 is the related intra-arterial push service.

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 96423PPRRVU2026_Oct_nonQPP.csv, line 12,807 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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