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CPT code 96440: Pleural chemotherapy, with thoracentesis2026 Medicare rate & RVUs in Hawaii, Guam, HI

Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration.

CMS RVU26DEffective Oct 1, 2026One payment locality40 Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $860.40 for 96440 in the office and $119.85 when it’s performed in a hospital or facility.

$860.40Office (non-facility)
$119.85Hospital or facility
+12.1%vs the national office rate ($767.55)

Check a contract rate as a % of Medicare · 96440 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 96440 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 96440 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 96440 covers

This service covers administration of an antineoplastic medication into the pleural space, with thoracentesis included as part of the procedure. It may be performed for a patient with malignant pleural disease when medication is instilled into the cavity after fluid is aspirated. The physician or other qualified practitioner accesses the pleural space, removes fluid, and administers the medication during the same service.

Report 96440 when the documented service includes pleural-cavity chemotherapy and the required thoracentesis; the aspiration is not separately reported as a second thoracentesis service. Documentation should identify the medication, route, pleural access, aspiration, and administration. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

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 Hawaii, Guam, HI compares for 96440

Across 109 of 109 payment localities, the office rate for 96440 runs from $667.70 in Arkansas to $1,079.07 in San Benito County, CA. Hawaii, Guam, HI pays $860.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

96440 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$860.40
  2. Los Angeles, CA · California$895.53+$35.13
  3. Washington, DC area · District of Columbia$895.09+$34.69
  4. Miami, FL · Florida$803.08−$57.32
  5. Chicago, IL · Illinois$777.56−$82.84
  6. Manhattan, NY · New York$886.94+$26.54
  7. Alaska · Alaska$845.84−$14.56

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

Every other payment area

96440 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$679.01$109.11
ArkansasArkansas$667.70$108.22
ArizonaArizona$745.43$114.30
Bakersfield, CACalifornia$833.51$119.66
Chico, CACalifornia$833.03$119.18
El Centro, CACalifornia$833.05$119.20
Fresno, CACalifornia$833.03$119.18
Hanford, CACalifornia$833.03$119.18

96440 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.

$667.70

$956.05

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

View every state and territory as a table
96440 office rate range by state
State / territoryOffice rate rangeLocalities
AK$845.841
AL$679.011
AR$667.701
AZ$745.431
CA$833.03–$1,079.0729
CO$811.671
CT$823.241
DC$895.091
DE$759.131
FL$739.45–$803.083
GA$693.71–$779.782
GU$860.401
HI$860.401
IA$705.911
ID$709.721
IL$709.98–$790.344
IN$714.631
KS$698.791
KY$690.341
LA$687.77–$727.362
MA$804.42–$904.202
MD$776.18–$895.093
ME$710.42–$759.602
MI$707.95–$746.542
MN$784.331
MO$671.93–$734.343
MS$670.131
MT$767.541
NC$719.501
ND$764.781
NE$711.351
NH$795.341
NJ$834.51–$883.062
NM$711.051
NV$767.461
NY$731.56–$906.895
OH$707.381
OK$692.461
OR$763.40–$844.312
PA$710.55–$798.102
PR$775.101
RI$791.231
SC$714.251
SD$764.451
TN$702.411
TX$704.93–$807.308
UT$725.551
VA$754.41–$895.092
VI$775.101
VT$758.321
WA$804.04–$927.342
WI$735.251
WV$678.911
WY$766.341

See 96440 in every payment locality

How the 96440 rate is calculated

Each of 96440’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 · 96440

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.12

2.12 RVUs× 1.000 GPCI

Practice expense20.72

20.72 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

22.9800

Conversion factor

$33.4009

Medicare rate

$767.55

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

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,809

Code
96440
Physician work
2.12
Practice expense
20.72
Malpractice
0.14

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 96440 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work2.12× 1.0002.1200
Practice expense20.72× 1.13723.5586
Malpractice0.14× 0.5790.0811
Total RVUs25.7597
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$860.40

Office: (2.12 × 1 + 20.72 × 1.137 + 0.14 × 0.579) × $33.4009 = $860.40

Facility: (2.12 × 1 + 1.22 × 1.137 + 0.14 × 0.579) × $33.4009 = $119.85

Open 96440 in the RVU calculator

Payment rules and modifiers for 96440

The CMS indicators that decide how 96440 is paid alongside other services.

CMS payment indicators · 96440

Pleural chemotherapy, with thoracentesis

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
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/technical0Physician service: no professional/technical split.

Codes related to 96440

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

Codes related to 96440
CodeHow it relatesOffice range, Hawaii, Guam, HI
Used instead
96446Chemotherapy administration, peritoneal cavity via catheterUsed for chemotherapy into the peritoneal cavity through an implanted port or catheter.$174.56
96450Chemotherapy administration, into central nervous systemUsed for chemotherapy administered into the central nervous system.$173.44
96405Intralesional chemotherapy, up to seven lesionsFor intralesional chemotherapy rather than administration into the pleural cavity.$93.14
96406Intralesional chemotherapy, more than seven lesionsFor intralesional chemotherapy when the lesion-count criteria for that code are met.$145.23
32555Thoracentesis, with imaging guidanceThoracentesis with imaging guidance when pleural drainage, not chemotherapy administration, is performed.$339.35

How 96440 has changed in Hawaii, Guam, HI

96440 · Office / nonfacility

$860.40

Effective 2026-10-01

The base rate is $77.37 higher than on 2025-10-01, moving from $783.03 to $860.40 (9.9%).

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

    $783.03changed to$860.40

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 19.15 changed to 20.72
    • Malpractice RVU 0.15 changed to 0.14
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $842.72changed to$783.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 20.12 changed to 19.15
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $828.97changed to$842.72

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $862.56changed to$828.97

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 20.28 changed to 20.12
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $908.74changed to$862.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 21.03 changed to 20.28
    • Malpractice RVU 0.12 changed to 0.14
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1120.58changed to$908.74

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 25.94 changed to 21.03
    • Malpractice RVU 0.48 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1022.85changed to$1120.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 22.64 changed to 25.94
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $958.16changed to$1022.85

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 21.08 changed to 22.64
    • Malpractice RVU 0.50 changed to 0.48
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $957.94changed to$958.16

    • Malpractice RVU 0.49 changed to 0.50

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $900.59changed to$957.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 19.71 changed to 21.08
    • Malpractice RVU 0.50 changed to 0.49

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $890.72changed to$900.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 19.41 changed to 19.71
    • Malpractice RVU 0.48 changed to 0.50
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $969.12changed to$890.72

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.37 changed to 2.12
    • Practice expense RVU 20.95 changed to 19.41
    • Malpractice RVU 0.56 changed to 0.48
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $986.81changed to$969.12

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 21.29 changed to 20.95

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $981.90changed to$986.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $967.24changed to$981.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 20.97 changed to 21.29
    • Malpractice RVU 0.52 changed to 0.56
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $1024.02changed to$967.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 23.70 changed to 20.97
    • Malpractice RVU 0.54 changed to 0.52
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  17. October 1, 2013

    RVU13D

    No ratechanged to$1024.02

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$860.40$119.85RVU26D
2026-07-01$860.40$119.85RVU26C
2026-04-01$860.40$119.85RVU26B
2026-01-01$860.40$119.85RVU26A
2025-10-01$783.03$137.45RVU25D
2025-07-01$783.03$137.45RVU25C
2025-04-01$783.03$137.45RVU25B
2025-01-01$783.03$137.45RVU25A
2024-10-01$842.72$140.12RVU24D
2024-07-01$842.72$140.12RVU24C
2024-04-01$842.72$140.12RVU24B
2024-03-09$842.72$140.12RVU24AR
2024-01-01$828.97$137.83RVU24A
2023-10-01$862.56$140.23RVU23D
2023-07-01$862.56$140.23RVU23C
2023-04-01$862.56$140.23RVU23B
2023-01-01$862.56$140.23RVU23A
2022-10-01$908.74$142.17RVU22D
2022-07-01$908.74$142.17RVU22C
2022-04-01$908.74$142.17RVU22B
2022-01-01$908.74$142.17RVU22A
2021-10-01$1,120.58$125.90RVU21D
2021-07-01$1,120.58$125.90RVU21C
2021-04-01$1,120.58$125.90RVU21B
2021-01-01$1,120.58$125.90RVU21A
2020-10-01$1,022.85$128.17RVU20D
2020-07-01$1,022.85$128.17RVU20C
2020-04-01$1,022.85$128.17RVU20B
2020-01-01$1,022.85$128.17RVU20A
2019-10-01$958.16$127.19RVU19D
2019-07-01$958.16$127.19RVU19C
2019-04-01$957.94$126.97RVU19B
2019-01-01$957.94$126.97RVU19A
2018-10-01$900.59$127.47RVU18D
2018-07-01$900.59$127.47RVU18C
2018-04-01$900.59$127.47RVU18B
2018-01-01$900.59$127.47RVU18AR1
2017-10-01$890.72$127.85RVU17D
2017-07-01$890.72$127.85RVU17C
2017-04-01$890.72$127.85RVU17B
2017-01-01$890.72$127.85RVU17A
2016-10-01$969.12$142.43RVU16D
2016-07-01$969.12$142.43RVU16C
2016-04-01$969.12$142.43RVU16B
2016-01-01$969.12$142.43RVU16A
2015-10-01$986.81$142.95RVU15D
2015-07-01$986.81$142.95RVU15C
2015-04-01$981.90$142.24RVU15B
2015-01-01$981.90$142.24RVU15A
2014-10-01$967.24$142.15RVU14D
2014-07-01$967.24$142.15RVU14C
2014-04-01$967.24$142.15RVU14B
2014-01-01$967.24$142.15RVU14A
2013-10-01$1,024.02$139.83RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 96440 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

96440 billing questions

Can I report a separate thoracentesis with 96440?

No. Thoracentesis is included in 96440 when performed as part of the pleural-cavity chemotherapy administration. A thoracentesis without chemotherapy is a different service.

How is 96440 different from 96446?

96440 is for medication delivered into the pleural cavity with thoracentesis. 96446 is for chemotherapy delivered into the peritoneal cavity through an implanted port or catheter.

Is modifier 50 appropriate for bilateral pleural treatment?

No. CMS identifies bilateral adjustment as inappropriate for 96440. Report the service based on the documented pleural-cavity administration rather than using modifier 50.

What documentation supports 96440?

Document the antineoplastic medication, pleural route, access and aspiration of fluid, and administration into the pleural cavity. The record should show that thoracentesis was part of the chemotherapy service.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is limited to cases with documented medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 96440PPRRVU2026_Oct_nonQPP.csv, line 12,809 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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