CPT code 96440: Pleural chemotherapy, with thoracentesis2026 Medicare rate & RVUs in North Dakota
Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration.
In North Dakota, Medicare pays $764.78 for 96440 in the office and $113.46 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Dakota 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. North Dakota pays $764.78. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$764.78
- Los Angeles, CA · California$895.53+$130.75
- Washington, DC area · District of Columbia$895.09+$130.31
- Miami, FL · Florida$803.08+$38.30
- Chicago, IL · Illinois$777.56+$12.78
- Manhattan, NY · New York$886.94+$122.16
- Alaska · Alaska$845.84+$81.06
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $833.03 | $119.18 |
| Merced, CACalifornia | $833.03 | $119.18 |
| Modesto, CACalifornia | $833.03 | $119.18 |
| Napa, CACalifornia | $989.79 | $131.35 |
| Oxnard, CACalifornia | $893.73 | $123.87 |
| Redding, CACalifornia | $833.03 | $119.18 |
| Rest of CaliforniaCalifornia | $833.03 | $119.18 |
| Riverside, CACalifornia | $834.58 | $120.73 |
| Sacramento, CACalifornia | $880.74 | $123.26 |
| Salinas, CACalifornia | $877.62 | $122.74 |
| San Diego, CACalifornia | $903.18 | $124.20 |
| Marin County, CACalifornia | $1,055.50 | $137.14 |
| San Francisco, CACalifornia | $1,055.34 | $136.98 |
| San Benito County, CACalifornia | $1,079.07 | $139.87 |
| Santa Clara County, CACalifornia | $1,078.42 | $139.22 |
| San Luis Obispo, CACalifornia | $862.78 | $120.93 |
| Santa Cruz, CACalifornia | $915.66 | $124.31 |
| Santa Maria, CACalifornia | $882.25 | $122.81 |
| Santa Rosa, CACalifornia | $925.30 | $125.48 |
| Stockton, CACalifornia | $833.03 | $119.18 |
| Vallejo, CACalifornia | $989.56 | $131.12 |
| Visalia, CACalifornia | $833.03 | $119.18 |
| Yuba City, CACalifornia | $833.03 | $119.18 |
| ColoradoColorado | $811.67 | $118.67 |
| ConnecticutConnecticut | $823.24 | $121.77 |
| DelawareDelaware | $759.13 | $115.63 |
| Fort Lauderdale, FLFlorida | $780.33 | $120.54 |
| Rest of FloridaFlorida | $739.45 | $116.79 |
| Atlanta, GAGeorgia | $779.78 | $118.04 |
| Rest of GeorgiaGeorgia | $693.71 | $112.73 |
| Hawaii, Guam, HIHawaii | $860.40 | $119.85 |
| IowaIowa | $705.91 | $109.95 |
| IdahoIdaho | $709.72 | $110.51 |
| East St. Louis, ILIllinois | $716.93 | $117.72 |
| Rest of IllinoisIllinois | $709.98 | $115.32 |
| Suburban Chicago, ILIllinois | $790.34 | $121.44 |
| IndianaIndiana | $714.63 | $110.86 |
| KansasKansas | $698.79 | $110.00 |
| KentuckyKentucky | $690.34 | $111.31 |
| New Orleans, LALouisiana | $727.36 | $114.47 |
| Rest of LouisianaLouisiana | $687.77 | $111.35 |
| Metropolitan Boston, MAMassachusetts | $904.20 | $126.53 |
| Rest of MassachusettsMassachusetts | $804.42 | $118.58 |
| Baltimore area, MDMaryland | $820.31 | $121.45 |
| Rest of MarylandMaryland | $776.18 | $117.05 |
| Rest of MaineMaine | $710.42 | $111.21 |
| Southern Maine, MEMaine | $759.60 | $114.14 |
| Detroit, MIMichigan | $746.54 | $118.02 |
| Rest of MichiganMichigan | $707.95 | $113.29 |
| MinnesotaMinnesota | $784.33 | $114.12 |
| Metropolitan Kansas City, MOMissouri | $725.23 | $113.64 |
| Metropolitan St. Louis, MOMissouri | $734.34 | $114.29 |
| Rest of MissouriMissouri | $671.93 | $110.49 |
| MississippiMississippi | $670.13 | $109.35 |
| MontanaMontana | $767.54 | $116.23 |
| North CarolinaNorth Carolina | $719.50 | $111.82 |
| NebraskaNebraska | $711.35 | $110.19 |
| New HampshireNew Hampshire | $795.34 | $117.32 |
| Northern New JerseyNew Jersey | $883.06 | $127.53 |
| Rest of New JerseyNew Jersey | $834.51 | $123.27 |
| New MexicoNew Mexico | $711.05 | $113.79 |
| NevadaNevada | $767.46 | $115.49 |
| NYC suburbs and Long Island, NYNew York | $906.89 | $132.48 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $837.47 | $124.27 |
| Queens, NYNew York | $900.11 | $130.25 |
| Rest of New YorkNew York | $731.56 | $112.81 |
| OhioOhio | $707.38 | $112.73 |
| OklahomaOklahoma | $692.46 | $110.83 |
| Portland, OROregon | $844.31 | $120.69 |
| Rest of OregonOregon | $763.40 | $114.68 |
| Metropolitan Philadelphia, PAPennsylvania | $798.10 | $120.08 |
| Rest of PennsylvaniaPennsylvania | $710.55 | $112.64 |
| Puerto RicoPuerto Rico | $775.10 | $116.61 |
| Rhode IslandRhode Island | $791.23 | $118.42 |
| South CarolinaSouth Carolina | $714.25 | $112.44 |
| South DakotaSouth Dakota | $764.45 | $113.13 |
| TennesseeTennessee | $702.41 | $110.36 |
| Austin, TXTexas | $807.30 | $118.21 |
| Beaumont, TXTexas | $704.93 | $112.24 |
| Brazoria, TXTexas | $760.86 | $115.41 |
| Dallas, TXTexas | $764.76 | $116.05 |
| Fort Worth, TXTexas | $757.90 | $115.70 |
| Galveston, TXTexas | $762.47 | $115.71 |
| Houston, TXTexas | $765.03 | $118.27 |
| Rest of TexasTexas | $731.80 | $113.70 |
| UtahUtah | $725.55 | $113.31 |
| VirginiaVirginia | $754.41 | $114.17 |
| Virgin Islands, VIUnited States Virgin Islands | $775.10 | $116.61 |
| VermontVermont | $758.32 | $113.52 |
| Rest of WashingtonWashington | $804.04 | $118.20 |
| King County, WAWashington | $927.34 | $128.17 |
| WisconsinWisconsin | $735.25 | $111.29 |
| West VirginiaWest Virginia | $678.91 | $112.91 |
| WyomingWyoming | $766.34 | $115.02 |
96440 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $845.84 | 1 |
| AL | $679.01 | 1 |
| AR | $667.70 | 1 |
| AZ | $745.43 | 1 |
| CA | $833.03–$1,079.07 | 29 |
| CO | $811.67 | 1 |
| CT | $823.24 | 1 |
| DC | $895.09 | 1 |
| DE | $759.13 | 1 |
| FL | $739.45–$803.08 | 3 |
| GA | $693.71–$779.78 | 2 |
| GU | $860.40 | 1 |
| HI | $860.40 | 1 |
| IA | $705.91 | 1 |
| ID | $709.72 | 1 |
| IL | $709.98–$790.34 | 4 |
| IN | $714.63 | 1 |
| KS | $698.79 | 1 |
| KY | $690.34 | 1 |
| LA | $687.77–$727.36 | 2 |
| MA | $804.42–$904.20 | 2 |
| MD | $776.18–$895.09 | 3 |
| ME | $710.42–$759.60 | 2 |
| MI | $707.95–$746.54 | 2 |
| MN | $784.33 | 1 |
| MO | $671.93–$734.34 | 3 |
| MS | $670.13 | 1 |
| MT | $767.54 | 1 |
| NC | $719.50 | 1 |
| ND | $764.78 | 1 |
| NE | $711.35 | 1 |
| NH | $795.34 | 1 |
| NJ | $834.51–$883.06 | 2 |
| NM | $711.05 | 1 |
| NV | $767.46 | 1 |
| NY | $731.56–$906.89 | 5 |
| OH | $707.38 | 1 |
| OK | $692.46 | 1 |
| OR | $763.40–$844.31 | 2 |
| PA | $710.55–$798.10 | 2 |
| PR | $775.10 | 1 |
| RI | $791.23 | 1 |
| SC | $714.25 | 1 |
| SD | $764.45 | 1 |
| TN | $702.41 | 1 |
| TX | $704.93–$807.30 | 8 |
| UT | $725.55 | 1 |
| VA | $754.41–$895.09 | 2 |
| VI | $775.10 | 1 |
| VT | $758.32 | 1 |
| WA | $804.04–$927.34 | 2 |
| WI | $735.25 | 1 |
| WV | $678.91 | 1 |
| WY | $766.34 | 1 |
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
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 North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.12 | × 1.000 | 2.1200 |
| Practice expense | 20.72 | × 1.000 | 20.7200 |
| Malpractice | 0.14 | × 0.406 | 0.0568 |
| Total RVUs | 22.8968 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$764.78
Office: (2.12 × 1 + 20.72 × 1 + 0.14 × 0.406) × $33.4009 = $764.78
Facility: (2.12 × 1 + 1.22 × 1 + 0.14 × 0.406) × $33.4009 = $113.46
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 96440 has changed in North Dakota
96440 · Office / nonfacility
$764.78
Effective 2026-10-01
The base rate is $74.26 higher than on 2025-10-01, moving from $690.52 to $764.78 (10.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$690.52changed to$764.78
- 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
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$742.72changed to$690.52
- 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.
March 9, 2024
RVU24AR
$730.60changed to$742.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$761.32changed to$730.60
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 20.28 changed to 20.12
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$802.92changed to$761.32
- 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
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$986.32changed to$802.92
- 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.
January 1, 2021
RVU21A
$901.98changed to$986.32
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 22.64 changed to 25.94
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$845.84changed to$901.98
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$845.64changed to$845.84
- Malpractice RVU 0.49 changed to 0.50
Held through RVU19D.
January 1, 2019
RVU19A
$795.59changed to$845.64
- 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.
January 1, 2018
RVU18AR1
$782.11changed to$795.59
- 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
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$846.06changed to$782.11
- 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
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$861.33changed to$846.06
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 21.29 changed to 20.95
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$857.05changed to$861.33
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$846.09changed to$857.05
- 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
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$896.48changed to$846.09
- 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
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $896.48
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $764.78 | $113.46 | RVU26D |
| 2026-07-01 | $764.78 | $113.46 | RVU26C |
| 2026-04-01 | $764.78 | $113.46 | RVU26B |
| 2026-01-01 | $764.78 | $113.46 | RVU26A |
| 2025-10-01 | $690.52 | $128.66 | RVU25D |
| 2025-07-01 | $690.52 | $128.66 | RVU25C |
| 2025-04-01 | $690.52 | $128.66 | RVU25B |
| 2025-01-01 | $690.52 | $128.66 | RVU25A |
| 2024-10-01 | $742.72 | $131.23 | RVU24D |
| 2024-07-01 | $742.72 | $131.23 | RVU24C |
| 2024-04-01 | $742.72 | $131.23 | RVU24B |
| 2024-03-09 | $742.72 | $131.23 | RVU24AR |
| 2024-01-01 | $730.60 | $129.09 | RVU24A |
| 2023-10-01 | $761.32 | $131.02 | RVU23D |
| 2023-07-01 | $761.32 | $131.02 | RVU23C |
| 2023-04-01 | $761.32 | $131.02 | RVU23B |
| 2023-01-01 | $761.32 | $131.02 | RVU23A |
| 2022-10-01 | $802.92 | $132.26 | RVU22D |
| 2022-07-01 | $802.92 | $132.26 | RVU22C |
| 2022-04-01 | $802.92 | $132.26 | RVU22B |
| 2022-01-01 | $802.92 | $132.26 | RVU22A |
| 2021-10-01 | $986.32 | $116.09 | RVU21D |
| 2021-07-01 | $986.32 | $116.09 | RVU21C |
| 2021-04-01 | $986.32 | $116.09 | RVU21B |
| 2021-01-01 | $986.32 | $116.09 | RVU21A |
| 2020-10-01 | $901.98 | $119.92 | RVU20D |
| 2020-07-01 | $901.98 | $119.92 | RVU20C |
| 2020-04-01 | $901.98 | $119.92 | RVU20B |
| 2020-01-01 | $901.98 | $119.92 | RVU20A |
| 2019-10-01 | $845.84 | $120.73 | RVU19D |
| 2019-07-01 | $845.84 | $120.73 | RVU19C |
| 2019-04-01 | $845.64 | $120.54 | RVU19B |
| 2019-01-01 | $845.64 | $120.54 | RVU19A |
| 2018-10-01 | $795.59 | $120.96 | RVU18D |
| 2018-07-01 | $795.59 | $120.96 | RVU18C |
| 2018-04-01 | $795.59 | $120.96 | RVU18B |
| 2018-01-01 | $795.59 | $120.96 | RVU18AR1 |
| 2017-10-01 | $782.11 | $121.04 | RVU17D |
| 2017-07-01 | $782.11 | $121.04 | RVU17C |
| 2017-04-01 | $782.11 | $121.04 | RVU17B |
| 2017-01-01 | $782.11 | $121.04 | RVU17A |
| 2016-10-01 | $846.06 | $134.63 | RVU16D |
| 2016-07-01 | $846.06 | $134.63 | RVU16C |
| 2016-04-01 | $846.06 | $134.63 | RVU16B |
| 2016-01-01 | $846.06 | $134.63 | RVU16A |
| 2015-10-01 | $861.33 | $135.12 | RVU15D |
| 2015-07-01 | $861.33 | $135.12 | RVU15C |
| 2015-04-01 | $857.05 | $134.45 | RVU15B |
| 2015-01-01 | $857.05 | $134.45 | RVU15A |
| 2014-10-01 | $846.09 | $133.57 | RVU14D |
| 2014-07-01 | $846.09 | $133.57 | RVU14C |
| 2014-04-01 | $846.09 | $133.57 | RVU14B |
| 2014-01-01 | $846.09 | $133.57 | RVU14A |
| 2013-10-01 | $896.48 | $130.28 | RVU13D |
| 2013-07-01 | $896.48 | $130.28 | RVU13C |
| 2013-04-01 | $896.48 | $130.28 | RVU13B |
| 2013-01-01 | $896.48 | $130.28 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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
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