$62.22–$100.01
Both codes cover subcutaneous or intramuscular antineoplastic administration. Choose 96402 for a hormonal antineoplastic agent and 96401 for a nonhormonal agent.
On this page
CMS RVU26D · Effective 2026-10-01
96402 Hormonal therapy injection Medicare reimbursement rates
Report this service when a hormonal antineoplastic drug is administered by subcutaneous or intramuscular injection, such as in oncology treatment. Compare 96402 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 96402?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$33.95–$53.16
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $19.21 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 96402 pays more and less
109 payment localities
$33.95 to $53.16
Chemotherapy administration
About 96402: Hormonal antineoplastic injection administration
Report this service when a hormonal antineoplastic drug is administered by subcutaneous or intramuscular injection, such as in oncology treatment.
This service covers administration of a hormonal antineoplastic agent by subcutaneous or intramuscular injection. It is commonly performed in an oncology or urology practice for cancer treatment, including administration of agents such as leuprolide, goserelin, or fulvestrant when used as hormonal antineoplastic therapy. The code represents the administration service, not the drug itself.
Select this code based on the agent’s hormonal antineoplastic role and the injection route; a nonhormonal antineoplastic injection uses a different administration code. Record the medication, indication, route, and administration in the clinical documentation. The drug may be reported separately when the practice supplies it and applicable drug-coding requirements are met. Under the CMS rule for this service, it is billed as an incident-to service only when performed under physician supervision.
CMS billing rules for 96402
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.19 · 16%
- Practice expense (office) RVU0.95 · 82%
- Malpractice RVU0.02 · 2%
335.4K
Medicare services in 2024 · #290 by national volume
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.
96402 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$13.88–$19.97
Use 96372 for a qualifying therapeutic, prophylactic, or diagnostic injection that is not an antineoplastic administration. Use 96402 for a hormonal antineoplastic agent.
$90.24–$146.28
Code 96409 describes antineoplastic administration by intravenous push. Code 96402 applies when the hormonal antineoplastic agent is given subcutaneously or intramuscularly.
See how rates vary across the country
96402 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$33.95
$47.38
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $43.68 | 1 |
| AL | $34.49 | 1 |
| AR | $33.95 | 1 |
| AZ | $37.67 | 1 |
| CA | $41.59–$53.16 | 29 |
| CO | $40.71 | 1 |
| CT | $41.46 | 1 |
| DC | $44.81 | 1 |
| DE | $38.33 | 1 |
| FL | $37.68–$41.07 | 3 |
| GA | $35.45–$39.41 | 2 |
| GU | $42.81 | 1 |
| HI | $42.81 | 1 |
| IA | $35.65 | 1 |
| ID | $35.85 | 1 |
| IL | $36.36–$40.16 | 4 |
| IN | $36.09 | 1 |
| KS | $35.37 | 1 |
| KY | $35.17 | 1 |
| LA | $35.07–$36.96 | 2 |
| MA | $40.39–$45.09 | 2 |
| MD | $39.13–$44.81 | 3 |
| ME | $35.95–$38.21 | 2 |
| MI | $36.07–$38.09 | 2 |
| MN | $39.19 | 1 |
| MO | $34.35–$37.22 | 3 |
| MS | $34.16 | 1 |
| MT | $38.74 | 1 |
| NC | $36.38 | 1 |
| ND | $38.35 | 1 |
| NE | $35.89 | 1 |
| NH | $39.96 | 1 |
| NJ | $41.98–$44.27 | 2 |
| NM | $36.25 | 1 |
| NV | $38.67 | 1 |
| NY | $36.96–$45.72 | 5 |
| OH | $35.99 | 1 |
| OK | $35.20 | 1 |
| OR | $38.42–$42.20 | 2 |
| PA | $36.11–$40.29 | 2 |
| PR | $39.08 | 1 |
| RI | $39.84 | 1 |
| SC | $36.23 | 1 |
| SD | $38.30 | 1 |
| TN | $35.55 | 1 |
| TX | $35.84–$40.52 | 8 |
| UT | $36.77 | 1 |
| VA | $38.01–$44.81 | 2 |
| VI | $39.08 | 1 |
| VT | $38.10 | 1 |
| WA | $40.35–$46.14 | 2 |
| WI | $36.95 | 1 |
| WV | $34.88 | 1 |
| WY | $38.57 | 1 |
Compare 96402 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $34.49 | Facility Unavailable |
| Alaska* | Office $43.68 | Facility Unavailable |
| Arizona | Office $37.67 | Facility Unavailable |
| Arkansas | Office $33.95 | Facility Unavailable |
| Atlanta | Office $39.41 | Facility Unavailable |
| Austin | Office $40.52 | Facility Unavailable |
| Bakersfield | Office $41.65 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $41.32 | Facility Unavailable |
| Beaumont | Office $35.84 | Facility Unavailable |
| Brazoria | Office $38.36 | Facility Unavailable |
| Chicago | Office $39.81 | Facility Unavailable |
| Chico | Office $41.59 | Facility Unavailable |
| Colorado | Office $40.71 | Facility Unavailable |
| Connecticut | Office $41.46 | Facility Unavailable |
| Dallas | Office $38.58 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $44.81 | Facility Unavailable |
| Delaware | Office $38.33 | Facility Unavailable |
| Detroit | Office $38.09 | Facility Unavailable |
| East St. Louis | Office $36.88 | Facility Unavailable |
| El Centro | Office $41.59 | Facility Unavailable |
| Fort Lauderdale | Office $39.70 | Facility Unavailable |
| Fort Worth | Office $38.27 | Facility Unavailable |
| Fresno | Office $41.59 | Facility Unavailable |
| Galveston | Office $38.46 | Facility Unavailable |
| Hanford-Corcoran | Office $41.59 | Facility Unavailable |
| Hawaii, Guam | Office $42.81 | Facility Unavailable |
| Houston | Office $38.82 | Facility Unavailable |
| Idaho | Office $35.85 | Facility Unavailable |
| Indiana | Office $36.09 | Facility Unavailable |
| Iowa | Office $35.65 | Facility Unavailable |
| Kansas | Office $35.37 | Facility Unavailable |
| Kentucky | Office $35.17 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $44.59 | Facility Unavailable |
| Madera | Office $41.59 | Facility Unavailable |
| Manhattan | Office $44.68 | Facility Unavailable |
| Merced | Office $41.59 | Facility Unavailable |
| Metropolitan Boston | Office $45.09 | Facility Unavailable |
| Metropolitan Kansas City | Office $36.79 | Facility Unavailable |
| Metropolitan Philadelphia | Office $40.29 | Facility Unavailable |
| Metropolitan St. Louis | Office $37.22 | Facility Unavailable |
| Miami | Office $41.07 | Facility Unavailable |
| Minnesota | Office $39.19 | Facility Unavailable |
| Mississippi | Office $34.16 | Facility Unavailable |
| Modesto | Office $41.59 | Facility Unavailable |
| Montana** | Office $38.74 | Facility Unavailable |
| Napa | Office $48.91 | Facility Unavailable |
| Nebraska | Office $35.89 | Facility Unavailable |
| Nevada** | Office $38.67 | Facility Unavailable |
| New Hampshire | Office $39.96 | Facility Unavailable |
| New Mexico | Office $36.25 | Facility Unavailable |
| New Orleans | Office $36.96 | Facility Unavailable |
| North Carolina | Office $36.38 | Facility Unavailable |
| North Dakota** | Office $38.35 | Facility Unavailable |
| Northern Nj | Office $44.27 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $45.72 | Facility Unavailable |
| Ohio | Office $35.99 | Facility Unavailable |
| Oklahoma | Office $35.20 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $44.45 | Facility Unavailable |
| Portland | Office $42.20 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $42.19 | Facility Unavailable |
| Puerto Rico | Office $39.08 | Facility Unavailable |
| Queens | Office $45.22 | Facility Unavailable |
| Redding | Office $41.59 | Facility Unavailable |
| Rest Of California | Office $41.59 | Facility Unavailable |
| Rest Of Florida | Office $37.68 | Facility Unavailable |
| Rest Of Georgia | Office $35.45 | Facility Unavailable |
| Rest Of Illinois | Office $36.36 | Facility Unavailable |
| Rest Of Louisiana | Office $35.07 | Facility Unavailable |
| Rest Of Maine | Office $35.95 | Facility Unavailable |
| Rest Of Maryland | Office $39.13 | Facility Unavailable |
| Rest Of Massachusetts | Office $40.39 | Facility Unavailable |
| Rest Of Michigan | Office $36.07 | Facility Unavailable |
| Rest Of Missouri | Office $34.35 | Facility Unavailable |
| Rest Of New Jersey | Office $41.98 | Facility Unavailable |
| Rest Of New York | Office $36.96 | Facility Unavailable |
| Rest Of Oregon | Office $38.42 | Facility Unavailable |
| Rest Of Pennsylvania | Office $36.11 | Facility Unavailable |
| Rest Of Texas | Office $37.06 | Facility Unavailable |
| Rest Of Washington | Office $40.35 | Facility Unavailable |
| Rhode Island | Office $39.84 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $41.81 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $43.84 | Facility Unavailable |
| Salinas | Office $43.68 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $44.85 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $52.00 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $51.97 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $53.16 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $53.07 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $42.95 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $45.39 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $43.88 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $45.86 | Facility Unavailable |
| Seattle (King Cnty) | Office $46.14 | Facility Unavailable |
| South Carolina | Office $36.23 | Facility Unavailable |
| South Dakota** | Office $38.30 | Facility Unavailable |
| Southern Maine | Office $38.21 | Facility Unavailable |
| Stockton | Office $41.59 | Facility Unavailable |
| Suburban Chicago | Office $40.16 | Facility Unavailable |
| Tennessee | Office $35.55 | Facility Unavailable |
| Utah | Office $36.77 | Facility Unavailable |
| Vallejo | Office $48.87 | Facility Unavailable |
| Vermont | Office $38.10 | Facility Unavailable |
| Virgin Islands | Office $39.08 | Facility Unavailable |
| Virginia | Office $38.01 | Facility Unavailable |
| Visalia | Office $41.59 | Facility Unavailable |
| West Virginia | Office $34.88 | Facility Unavailable |
| Wisconsin | Office $36.95 | Facility Unavailable |
| Wyoming** | Office $38.57 | Facility Unavailable |
| Yuba City | Office $41.59 | Facility Unavailable |
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96402 billing questions
How does this differ from 96401?
Use 96402 for a hormonal antineoplastic agent given subcutaneously or intramuscularly. Code 96401 is for a nonhormonal antineoplastic agent by those routes.
Can the drug be billed separately?
The administration code covers the injection service, not the medication. When the practice supplies the drug, report the appropriate drug code separately if applicable.
Can this be billed for any subcutaneous or intramuscular injection?
No. The agent must be a hormonal antineoplastic drug. A routine therapeutic injection, such as a non-antineoplastic medication, is not reported with this code.
What documentation supports reporting 96402?
Document the hormonal antineoplastic agent, its cancer-treatment indication, the subcutaneous or intramuscular route, and that the injection was administered.
What supervision is required for Medicare billing?
CMS specifies that this incident-to service is billed only when performed under physician supervision.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,79396380,,Admn rsv monoc antb im cnsl,A,,0.28,0.60,,0.60,NA,0.02,0.90,0.90,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79496381,,Admn rsv monoc antb im njx,A,,0.17,0.55,,0.55,NA,0.01,0.73,0.73,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79596401,,Chemo anti-neopl sq/im,A,,0.21,1.90,,1.90,NA,0.04,2.15,2.15,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79696402,,Chemo hormon antineopl sq/im,A,,0.19,0.95,,0.95,NA,0.02,1.16,1.16,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79796405,,Chemo intralesional up to 7,A,,0.52,1.98,,0.16,,0.03,2.53,0.71,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79896406,,Chemo intralesional over 7,A,,0.80,3.09,,0.26,,0.06,3.95,1.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79996409,,Chemo iv push sngl drug,A,,0.24,2.83,,2.83,NA,0.06,3.13,3.13,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00