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CMS RVU26D · Effective 2026-10-01

96409 in Beaumont

Office / nonfacility

$95.90

Base rate per service

Facility setting

Not available in this setting

Base rate per service

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.

Chemotherapy administration

About 96409: Single-drug intravenous chemotherapy push

Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug.

This service covers administration of an antineoplastic drug through venous access by a brief intravenous push, rather than by a timed infusion. It is commonly performed by oncology nursing staff in an office or outpatient cancer clinic. The code represents one drug administered by this method; the drug itself is generally reported separately when separately payable and supported by the record.

Select this code when the documented route and method are intravenous push and the service is for a single or initial drug. The medication administration record should identify the drug, dose, route, and administration method; document additional drugs and their sequence when applicable. An additional chemotherapy drug given by IV push may be reported with 96411. For Medicare, this is an incident-to service and is billed only when performed under physician supervision.

CMS billing rules for 96409

Professional and technical components
Incident-to service: billed only when performed under physician supervision.

Where the value comes from

  • Work RVU0.24 · 8%
  • Practice expense (office) RVU2.83 · 90%
  • Malpractice RVU0.06 · 2%

37.4K

Medicare services in 2024 · #893 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.

96409 compared with similar codes

Office rates for Beaumont, from the same CMS release.

96411

IV chemotherapy push

Each additional drug

$52.60

96409 represents the single or initial drug given by IV push. 96411 represents an additional chemotherapy drug administered by IV push.

96413

Chemo IV infusion

Initial drug, first hour

$122.16

Choose 96409 for administration by IV push; choose 96413 when the drug is delivered by IV infusion over time.

96401

Chemotherapy injection

Subcutaneous or intramuscular, nonhormonal

$66.01

96401 is for chemotherapy given subcutaneously or intramuscularly. 96409 is for chemotherapy delivered through venous access by IV push.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 96409 is $109.81—$13.91 higher than the $95.90 rate in Beaumont. Both use the same code, release and participation basis.

96409 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $95.90

  2. Austin

    $109.81

    $13.91 higher than Beaumont

  3. Brazoria

    $103.32

    $7.42 higher than Beaumont

  4. Dallas

    $103.95

    $8.05 higher than Beaumont

  5. Fort Worth

    $103.04

    $7.14 higher than Beaumont

  6. Galveston

    $103.60

    $7.70 higher than Beaumont

  7. Houston

    $104.70

    $8.80 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 96409 ranges from $90.24 in Arkansas to $146.28 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 96409

    Office

    $99.53

    Facility

    Unavailable

    $3.63 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 96409

    Office

    $121.50

    Facility

    Unavailable

    $25.60 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96409

    Office

    $122.03

    Facility

    Unavailable

    $26.13 higher than Beaumont for the office setting.

  • Miami

    Florida · 96409

    Office

    $111.48

    Facility

    Unavailable

    $15.58 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 96409

    Office

    $107.67

    Facility

    Unavailable

    $11.77 higher than Beaumont for the office setting.

  • Manhattan

    New York · 96409

    Office

    $121.55

    Facility

    Unavailable

    $25.65 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 96409

    Office

    $113.80

    Facility

    Unavailable

    $17.90 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 96409

    Office

    $91.86

    Facility

    Unavailable

    $4.04 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 96409

    Office

    $90.24

    Facility

    Unavailable

    $5.66 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 96409

    Office

    $101.33

    Facility

    Unavailable

    $5.43 higher than Beaumont for the office setting.

  • Bakersfield

    California · 96409

    Office

    $112.99

    Facility

    Unavailable

    $17.09 higher than Beaumont for the office setting.

  • Chico

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • El Centro

    California · 96409

    Office

    $112.84

    Facility

    Unavailable

    $16.94 higher than Beaumont for the office setting.

  • Fresno

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Madera

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Merced

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Modesto

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Napa

    California · 96409

    Office

    $134.12

    Facility

    Unavailable

    $38.22 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96409

    Office

    $121.22

    Facility

    Unavailable

    $25.32 higher than Beaumont for the office setting.

  • Redding

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Rest Of California

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96409

    Office

    $113.47

    Facility

    Unavailable

    $17.57 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96409

    Office

    $119.31

    Facility

    Unavailable

    $23.41 higher than Beaumont for the office setting.

  • Salinas

    California · 96409

    Office

    $118.89

    Facility

    Unavailable

    $22.99 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96409

    Office

    $122.39

    Facility

    Unavailable

    $26.49 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96409

    Office

    $142.98

    Facility

    Unavailable

    $47.08 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 96409

    Office

    $142.91

    Facility

    Unavailable

    $47.01 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 96409

    Office

    $146.28

    Facility

    Unavailable

    $50.38 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 96409

    Office

    $146.00

    Facility

    Unavailable

    $50.10 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96409

    Office

    $116.89

    Facility

    Unavailable

    $20.99 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 96409

    Office

    $124.11

    Facility

    Unavailable

    $28.21 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 96409

    Office

    $119.53

    Facility

    Unavailable

    $23.63 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 96409

    Office

    $125.41

    Facility

    Unavailable

    $29.51 higher than Beaumont for the office setting.

  • Stockton

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Vallejo

    California · 96409

    Office

    $134.02

    Facility

    Unavailable

    $38.12 higher than Beaumont for the office setting.

  • Visalia

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Yuba City

    California · 96409

    Office

    $112.83

    Facility

    Unavailable

    $16.93 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 96409

    Office

    $110.25

    Facility

    Unavailable

    $14.35 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 96409

    Office

    $112.40

    Facility

    Unavailable

    $16.50 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 96409

    Office

    $103.25

    Facility

    Unavailable

    $7.35 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 96409

    Office

    $107.39

    Facility

    Unavailable

    $11.49 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 96409

    Office

    $101.39

    Facility

    Unavailable

    $5.49 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 96409

    Office

    $106.48

    Facility

    Unavailable

    $10.58 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 96409

    Office

    $94.72

    Facility

    Unavailable

    $1.18 lower than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 96409

    Office

    $116.65

    Facility

    Unavailable

    $20.75 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 96409

    Office

    $95.30

    Facility

    Unavailable

    $0.60 lower than Beaumont for the office setting.

  • Idaho

    Idaho · 96409

    Office

    $95.93

    Facility

    Unavailable

    $0.03 higher than Beaumont for the office setting.

  • East St. Louis

    Illinois · 96409

    Office

    $99.01

    Facility

    Unavailable

    $3.11 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 96409

    Office

    $97.45

    Facility

    Unavailable

    $1.55 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 96409

    Office

    $108.70

    Facility

    Unavailable

    $12.80 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 96409

    Office

    $96.61

    Facility

    Unavailable

    $0.71 higher than Beaumont for the office setting.

  • Kansas

    Kansas · 96409

    Office

    $94.48

    Facility

    Unavailable

    $1.42 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 96409

    Office

    $93.88

    Facility

    Unavailable

    $2.02 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 96409

    Office

    $99.24

    Facility

    Unavailable

    $3.34 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 96409

    Office

    $93.59

    Facility

    Unavailable

    $2.31 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 96409

    Office

    $122.99

    Facility

    Unavailable

    $27.09 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96409

    Office

    $109.28

    Facility

    Unavailable

    $13.38 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96409

    Office

    $112.05

    Facility

    Unavailable

    $16.15 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 96409

    Office

    $105.59

    Facility

    Unavailable

    $9.69 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 96409

    Office

    $96.23

    Facility

    Unavailable

    $0.33 higher than Beaumont for the office setting.

  • Southern Maine

    Maine · 96409

    Office

    $102.95

    Facility

    Unavailable

    $7.05 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 96409

    Office

    $102.61

    Facility

    Unavailable

    $6.71 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 96409

    Office

    $96.58

    Facility

    Unavailable

    $0.68 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 96409

    Office

    $105.88

    Facility

    Unavailable

    $9.98 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 96409

    Office

    $98.73

    Facility

    Unavailable

    $2.83 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 96409

    Office

    $100.01

    Facility

    Unavailable

    $4.11 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 96409

    Office

    $91.45

    Facility

    Unavailable

    $4.45 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 96409

    Office

    $90.88

    Facility

    Unavailable

    $5.02 lower than Beaumont for the office setting.

  • Montana**

    Montana · 96409

    Office

    $104.54

    Facility

    Unavailable

    $8.64 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 96409

    Office

    $97.49

    Facility

    Unavailable

    $1.59 higher than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 96409

    Office

    $103.35

    Facility

    Unavailable

    $7.45 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 96409

    Office

    $96.02

    Facility

    Unavailable

    $0.12 higher than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 96409

    Office

    $108.17

    Facility

    Unavailable

    $12.27 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 96409

    Office

    $120.31

    Facility

    Unavailable

    $24.41 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 96409

    Office

    $113.76

    Facility

    Unavailable

    $17.86 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 96409

    Office

    $97.10

    Facility

    Unavailable

    $1.20 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 96409

    Office

    $104.30

    Facility

    Unavailable

    $8.40 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96409

    Office

    $124.64

    Facility

    Unavailable

    $28.74 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96409

    Office

    $114.31

    Facility

    Unavailable

    $18.41 higher than Beaumont for the office setting.

  • Queens

    New York · 96409

    Office

    $123.15

    Facility

    Unavailable

    $27.25 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 96409

    Office

    $99.22

    Facility

    Unavailable

    $3.32 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 96409

    Office

    $96.34

    Facility

    Unavailable

    $0.44 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 96409

    Office

    $93.98

    Facility

    Unavailable

    $1.92 lower than Beaumont for the office setting.

  • Portland

    Oregon · 96409

    Office

    $114.65

    Facility

    Unavailable

    $18.75 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 96409

    Office

    $103.57

    Facility

    Unavailable

    $7.67 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96409

    Office

    $108.95

    Facility

    Unavailable

    $13.05 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96409

    Office

    $96.68

    Facility

    Unavailable

    $0.78 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 96409

    Office

    $105.55

    Facility

    Unavailable

    $9.65 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 96409

    Office

    $107.60

    Facility

    Unavailable

    $11.70 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 96409

    Office

    $97.06

    Facility

    Unavailable

    $1.16 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 96409

    Office

    $103.21

    Facility

    Unavailable

    $7.31 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 96409

    Office

    $95.02

    Facility

    Unavailable

    $0.88 lower than Beaumont for the office setting.

  • Utah

    Utah · 96409

    Office

    $98.67

    Facility

    Unavailable

    $2.77 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 96409

    Office

    $102.35

    Facility

    Unavailable

    $6.45 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96409

    Office

    $105.55

    Facility

    Unavailable

    $9.65 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 96409

    Office

    $102.61

    Facility

    Unavailable

    $6.71 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 96409

    Office

    $109.18

    Facility

    Unavailable

    $13.28 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 96409

    Office

    $126.04

    Facility

    Unavailable

    $30.14 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 96409

    Office

    $99.19

    Facility

    Unavailable

    $3.29 higher than Beaumont for the office setting.

  • West Virginia

    West Virginia · 96409

    Office

    $93.03

    Facility

    Unavailable

    $2.87 lower than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 96409

    Office

    $104.02

    Facility

    Unavailable

    $8.12 higher than Beaumont for the office setting.

See how rates vary across the country

96409 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$90.24

$129.56

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$113.801
AL$91.861
AR$90.241
AZ$101.331
CA$112.83–$146.2829
CO$110.251
CT$112.401
DC$122.031
DE$103.251
FL$101.39–$111.483
GA$94.72–$106.482
GU$116.651
HI$116.651
IA$95.301
ID$95.931
IL$97.45–$108.704
IN$96.611
KS$94.481
KY$93.881
LA$93.59–$99.242
MA$109.28–$122.992
MD$105.59–$122.033
ME$96.23–$102.952
MI$96.58–$102.612
MN$105.881
MO$91.45–$100.013
MS$90.881
MT$104.541
NC$97.491
ND$103.351
NE$96.021
NH$108.171
NJ$113.76–$120.312
NM$97.101
NV$104.301
NY$99.22–$124.645
OH$96.341
OK$93.981
OR$103.57–$114.652
PA$96.68–$108.952
PR$105.551
RI$107.601
SC$97.061
SD$103.211
TN$95.021
TX$95.90–$109.818
UT$98.671
VA$102.35–$122.032
VI$105.551
VT$102.611
WA$109.18–$126.042
WI$99.191
WV$93.031
WY$104.021

Explore 96409 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96409 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$105.49

$95.90 × 110% = $105.49

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96409 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

12,799

Code
96409
Physician work
0.24
Practice expense
2.83
Malpractice
0.06

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 96409 in Beaumont
ComponentRVULocality factorAdjusted
Physician work0.24× 1.0000.2400
Practice expense2.83× 0.9102.5753
Malpractice0.06× 0.9290.0557
Total RVUs2.8710
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$95.90

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 96409 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.241
Practice expense2.830.91
Malpractice0.060.929

(0.24 × 1 + 2.83 × 0.91 + 0.06 × 0.929) × $33.4009 = $95.90

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

96409 · Office / nonfacility

$95.90

Effective 2026-10-01

The base rate is $11.54 higher than on 2025-10-01, moving from $84.36 to $95.90 (13.7%).

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

    $84.36changed to$95.90

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.57 changed to 2.83
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $84.36

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$95.90Not available in this settingRVU26D
2026-07-01$95.90Not available in this settingRVU26C
2026-04-01$95.90Not available in this settingRVU26B
2026-01-01$95.90Not available in this settingRVU26A
2025-10-01$84.36Not available in this settingRVU25D
2025-07-01$84.36Not available in this settingRVU25C
2025-04-01$84.36Not available in this settingRVU25B
2025-01-01$84.36Not available in this settingRVU25A

96409 billing questions

When should 96409 be used instead of 96411?

Use 96409 for the single or initial chemotherapy drug given by IV push. Report 96411 for an additional chemotherapy drug administered by IV push in the same treatment.

How does 96409 differ from 96413?

96409 describes a brief IV push. Use 96413 when the chemotherapy is administered by IV infusion over time, rather than by push.

Is the chemotherapy drug included in 96409?

The code represents the administration service, not the drug supply. Report the drug separately when it is separately payable and the record supports it.

What documentation supports 96409?

The medication administration record should identify the antineoplastic drug, dose, IV route, and push method. Record any additional drugs and their sequence to support use of 96411 when applicable.

What Medicare supervision condition applies?

Medicare treats 96409 as an incident-to service. It may be 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.

RVUs for 96409PPRRVU2026_Oct_nonQPP.csv, line 12,799 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet