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CMS RVU26D · Effective 2026-10-01

96369 in El Centro

Office / nonfacility

$157.77

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.

Medication administration

About 96369: Initial subcutaneous therapeutic infusion

Reports the initial, up-to-one-hour service for a therapeutic or prophylactic medication delivered by subcutaneous infusion rather than a single injection.

This service covers starting a therapeutic or prophylactic medication infusion through a subcutaneous site, including setting up the infusion and establishing the site or sites. It is distinct from a one-time subcutaneous injection: the medication is delivered by infusion, commonly using an infusion pump. In an office setting, clinical staff may perform the administration as part of the physician-supervised service.

Report 96369 for the initial infusion service, up to one hour; documentation should support the medication, subcutaneous route, infusion start and stop times, and work performed to establish the infusion. For Medicare, this is an incident-to service and may be billed only when performed under physician supervision. The drug itself is not the administration service represented by this code; report it separately when appropriate under the applicable drug billing rules.

CMS billing rules for 96369

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

Where the value comes from

  • Work RVU0.21 · 5%
  • Practice expense (office) RVU4.10 · 94%
  • Malpractice RVU0.03 · 1%

7.1K

Medicare services in 2024 · #1654 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.

96369 compared with similar codes

Office rates for El Centro, from the same CMS release.

96370

Subcutaneous infusion

Each additional hour

$18.01

96369 reports the initial subcutaneous infusion service, up to one hour. 96370 is used for qualifying additional infusion time.

96371

Infusion setup

Additional pump setup or site

$61.87

96369 reports the initial subcutaneous infusion service. 96371 is for an additional pump setup or establishment of another subcutaneous infusion site.

96372

SC/IM injection

Therapeutic, prophylactic, or diagnostic

$16.21

96372 reports a single subcutaneous or intramuscular injection. 96369 is for medication delivered by subcutaneous infusion.

96365

IV drug infusion

Initial, first hour

$72.29

Both codes describe an initial therapeutic, prophylactic, or diagnostic infusion, but 96365 is intravenous and 96369 is subcutaneous.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 96369 is $157.85—$0.08 higher than the $157.77 rate in El Centro. Both use the same code, release and participation basis.

96369 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $157.77

  2. Bakersfield

    $157.85

    $0.08 higher than El Centro

  3. Chico

    $157.76

    $0.01 lower than El Centro

  4. Fresno

    $157.76

    $0.01 lower than El Centro

  5. Hanford-Corcoran

    $157.76

    $0.01 lower than El Centro

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $169.97

    $12.20 higher than El Centro

  7. Madera

    $157.76

    $0.01 lower than El Centro

Other payment areas listed in California 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, 96369 ranges from $125.16 in Arkansas to $205.80 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

  • Merced

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Modesto

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Napa

    California · 96369

    Office

    $188.46

    Facility

    Unavailable

    $30.69 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96369

    Office

    $169.70

    Facility

    Unavailable

    $11.93 higher than El Centro for the office setting.

  • Redding

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Rest Of California

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96369

    Office

    $158.09

    Facility

    Unavailable

    $0.32 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96369

    Office

    $167.07

    Facility

    Unavailable

    $9.30 higher than El Centro for the office setting.

  • Salinas

    California · 96369

    Office

    $166.49

    Facility

    Unavailable

    $8.72 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96369

    Office

    $171.55

    Facility

    Unavailable

    $13.78 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96369

    Office

    $201.23

    Facility

    Unavailable

    $43.46 higher than El Centro for the office setting.

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

    California · 96369

    Office

    $201.20

    Facility

    Unavailable

    $43.43 higher than El Centro for the office setting.

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

    California · 96369

    Office

    $205.80

    Facility

    Unavailable

    $48.03 higher than El Centro for the office setting.

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

    California · 96369

    Office

    $205.66

    Facility

    Unavailable

    $47.89 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96369

    Office

    $163.65

    Facility

    Unavailable

    $5.88 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 96369

    Office

    $174.09

    Facility

    Unavailable

    $16.32 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 96369

    Office

    $167.42

    Facility

    Unavailable

    $9.65 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 96369

    Office

    $175.93

    Facility

    Unavailable

    $18.16 higher than El Centro for the office setting.

  • Stockton

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Vallejo

    California · 96369

    Office

    $188.41

    Facility

    Unavailable

    $30.64 higher than El Centro for the office setting.

  • Visalia

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Yuba City

    California · 96369

    Office

    $157.76

    Facility

    Unavailable

    $0.01 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96369

    Office

    $169.83

    Facility

    Unavailable

    $12.06 higher than El Centro for the office setting.

  • Miami

    Florida · 96369

    Office

    $152.11

    Facility

    Unavailable

    $5.66 lower than El Centro for the office setting.

  • Chicago

    Illinois · 96369

    Office

    $146.99

    Facility

    Unavailable

    $10.78 lower than El Centro for the office setting.

  • Manhattan

    New York · 96369

    Office

    $168.18

    Facility

    Unavailable

    $10.41 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 96369

    Office

    $156.92

    Facility

    Unavailable

    $0.85 lower than El Centro for the office setting.

  • Alabama

    Alabama · 96369

    Office

    $127.41

    Facility

    Unavailable

    $30.36 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 96369

    Office

    $125.16

    Facility

    Unavailable

    $32.61 lower than El Centro for the office setting.

  • Arizona

    Arizona · 96369

    Office

    $140.57

    Facility

    Unavailable

    $17.20 lower than El Centro for the office setting.

  • Colorado

    Colorado · 96369

    Office

    $153.59

    Facility

    Unavailable

    $4.18 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 96369

    Office

    $155.86

    Facility

    Unavailable

    $1.91 lower than El Centro for the office setting.

  • Delaware

    Delaware · 96369

    Office

    $143.25

    Facility

    Unavailable

    $14.52 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 96369

    Office

    $147.55

    Facility

    Unavailable

    $10.22 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 96369

    Office

    $139.44

    Facility

    Unavailable

    $18.33 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 96369

    Office

    $147.37

    Facility

    Unavailable

    $10.40 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 96369

    Office

    $130.36

    Facility

    Unavailable

    $27.41 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 96369

    Office

    $163.30

    Facility

    Unavailable

    $5.53 higher than El Centro for the office setting.

  • Iowa

    Iowa · 96369

    Office

    $132.72

    Facility

    Unavailable

    $25.05 lower than El Centro for the office setting.

  • Idaho

    Idaho · 96369

    Office

    $133.48

    Facility

    Unavailable

    $24.29 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 96369

    Office

    $135.02

    Facility

    Unavailable

    $22.75 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 96369

    Office

    $133.61

    Facility

    Unavailable

    $24.16 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 96369

    Office

    $149.48

    Facility

    Unavailable

    $8.29 lower than El Centro for the office setting.

  • Indiana

    Indiana · 96369

    Office

    $134.45

    Facility

    Unavailable

    $23.32 lower than El Centro for the office setting.

  • Kansas

    Kansas · 96369

    Office

    $131.32

    Facility

    Unavailable

    $26.45 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 96369

    Office

    $129.67

    Facility

    Unavailable

    $28.10 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 96369

    Office

    $137.02

    Facility

    Unavailable

    $20.75 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 96369

    Office

    $129.17

    Facility

    Unavailable

    $28.60 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 96369

    Office

    $171.70

    Facility

    Unavailable

    $13.93 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96369

    Office

    $152.13

    Facility

    Unavailable

    $5.64 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96369

    Office

    $155.31

    Facility

    Unavailable

    $2.46 lower than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 96369

    Office

    $146.59

    Facility

    Unavailable

    $11.18 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 96369

    Office

    $133.63

    Facility

    Unavailable

    $24.14 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 96369

    Office

    $143.36

    Facility

    Unavailable

    $14.41 lower than El Centro for the office setting.

  • Detroit

    Michigan · 96369

    Office

    $140.85

    Facility

    Unavailable

    $16.92 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 96369

    Office

    $133.18

    Facility

    Unavailable

    $24.59 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 96369

    Office

    $148.23

    Facility

    Unavailable

    $9.54 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 96369

    Office

    $136.58

    Facility

    Unavailable

    $21.19 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 96369

    Office

    $138.39

    Facility

    Unavailable

    $19.38 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 96369

    Office

    $126.04

    Facility

    Unavailable

    $31.73 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 96369

    Office

    $125.66

    Facility

    Unavailable

    $32.11 lower than El Centro for the office setting.

  • Montana**

    Montana · 96369

    Office

    $144.96

    Facility

    Unavailable

    $12.81 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 96369

    Office

    $135.42

    Facility

    Unavailable

    $22.35 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 96369

    Office

    $144.36

    Facility

    Unavailable

    $13.41 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 96369

    Office

    $133.79

    Facility

    Unavailable

    $23.98 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 96369

    Office

    $150.45

    Facility

    Unavailable

    $7.32 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 96369

    Office

    $167.38

    Facility

    Unavailable

    $9.61 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 96369

    Office

    $157.94

    Facility

    Unavailable

    $0.17 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 96369

    Office

    $133.79

    Facility

    Unavailable

    $23.98 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 96369

    Office

    $144.93

    Facility

    Unavailable

    $12.84 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96369

    Office

    $172.15

    Facility

    Unavailable

    $14.38 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96369

    Office

    $158.50

    Facility

    Unavailable

    $0.73 higher than El Centro for the office setting.

  • Queens

    New York · 96369

    Office

    $170.78

    Facility

    Unavailable

    $13.01 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 96369

    Office

    $137.82

    Facility

    Unavailable

    $19.95 lower than El Centro for the office setting.

  • Ohio

    Ohio · 96369

    Office

    $133.05

    Facility

    Unavailable

    $24.72 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 96369

    Office

    $130.08

    Facility

    Unavailable

    $27.69 lower than El Centro for the office setting.

  • Portland

    Oregon · 96369

    Office

    $160.02

    Facility

    Unavailable

    $2.25 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 96369

    Office

    $144.11

    Facility

    Unavailable

    $13.66 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96369

    Office

    $150.89

    Facility

    Unavailable

    $6.88 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96369

    Office

    $133.68

    Facility

    Unavailable

    $24.09 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 96369

    Office

    $146.45

    Facility

    Unavailable

    $11.32 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 96369

    Office

    $149.50

    Facility

    Unavailable

    $8.27 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 96369

    Office

    $134.40

    Facility

    Unavailable

    $23.37 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 96369

    Office

    $144.29

    Facility

    Unavailable

    $13.48 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 96369

    Office

    $132.03

    Facility

    Unavailable

    $25.74 lower than El Centro for the office setting.

  • Austin

    Texas · 96369

    Office

    $152.80

    Facility

    Unavailable

    $4.97 lower than El Centro for the office setting.

  • Beaumont

    Texas · 96369

    Office

    $132.56

    Facility

    Unavailable

    $25.21 lower than El Centro for the office setting.

  • Brazoria

    Texas · 96369

    Office

    $143.56

    Facility

    Unavailable

    $14.21 lower than El Centro for the office setting.

  • Dallas

    Texas · 96369

    Office

    $144.33

    Facility

    Unavailable

    $13.44 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 96369

    Office

    $142.98

    Facility

    Unavailable

    $14.79 lower than El Centro for the office setting.

  • Galveston

    Texas · 96369

    Office

    $143.89

    Facility

    Unavailable

    $13.88 lower than El Centro for the office setting.

  • Houston

    Texas · 96369

    Office

    $144.43

    Facility

    Unavailable

    $13.34 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 96369

    Office

    $137.88

    Facility

    Unavailable

    $19.89 lower than El Centro for the office setting.

  • Utah

    Utah · 96369

    Office

    $136.64

    Facility

    Unavailable

    $21.13 lower than El Centro for the office setting.

  • Virginia

    Virginia · 96369

    Office

    $142.34

    Facility

    Unavailable

    $15.43 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96369

    Office

    $146.45

    Facility

    Unavailable

    $11.32 lower than El Centro for the office setting.

  • Vermont

    Vermont · 96369

    Office

    $143.10

    Facility

    Unavailable

    $14.67 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 96369

    Office

    $152.07

    Facility

    Unavailable

    $5.70 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 96369

    Office

    $176.21

    Facility

    Unavailable

    $18.44 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 96369

    Office

    $138.51

    Facility

    Unavailable

    $19.26 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 96369

    Office

    $127.45

    Facility

    Unavailable

    $30.32 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 96369

    Office

    $144.70

    Facility

    Unavailable

    $13.07 lower than El Centro for the office setting.

See how rates vary across the country

96369 · 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.

$125.16

$181.78

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$156.921
AL$127.411
AR$125.161
AZ$140.571
CA$157.76–$205.8029
CO$153.591
CT$155.861
DC$169.831
DE$143.251
FL$139.44–$152.113
GA$130.36–$147.372
GU$163.301
HI$163.301
IA$132.721
ID$133.481
IL$133.61–$149.484
IN$134.451
KS$131.321
KY$129.671
LA$129.17–$137.022
MA$152.13–$171.702
MD$146.59–$169.833
ME$133.63–$143.362
MI$133.18–$140.852
MN$148.231
MO$126.04–$138.393
MS$125.661
MT$144.961
NC$135.421
ND$144.361
NE$133.791
NH$150.451
NJ$157.94–$167.382
NM$133.791
NV$144.931
NY$137.82–$172.155
OH$133.051
OK$130.081
OR$144.11–$160.022
PA$133.68–$150.892
PR$146.451
RI$149.501
SC$134.401
SD$144.291
TN$132.031
TX$132.56–$152.808
UT$136.641
VA$142.34–$169.832
VI$146.451
VT$143.101
WA$152.07–$176.212
WI$138.511
WV$127.451
WY$144.701

Explore 96369 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, 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 California →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96369 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$173.55

$157.77 × 110% = $173.55

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.

Compare your contract offer →

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 96369 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

12,783

Code
96369
Physician work
0.21
Practice expense
4.10
Malpractice
0.03

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 96369 in El Centro
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0170.2136
Practice expense4.10× 1.0964.4936
Malpractice0.03× 0.5410.0162
Total RVUs4.7234
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$157.77

Open 96369 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.211.017
Practice expense4.11.096
Malpractice0.030.541

(0.21 × 1.017 + 4.1 × 1.096 + 0.03 × 0.541) × $33.4009 = $157.77

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

96369 · Office / nonfacility

$157.77

Effective 2026-10-01

The base rate is $12.09 higher than on 2025-10-01, moving from $145.68 to $157.77 (8.3%).

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

    $145.68changed to$157.77

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.91 changed to 4.10
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $145.68

    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$157.77Not available in this settingRVU26D
2026-07-01$157.77Not available in this settingRVU26C
2026-04-01$157.77Not available in this settingRVU26B
2026-01-01$157.77Not available in this settingRVU26A
2025-10-01$145.68Not available in this settingRVU25D
2025-07-01$145.68Not available in this settingRVU25C
2025-04-01$145.68Not available in this settingRVU25B
2025-01-01$145.68Not available in this settingRVU25A

96369 billing questions

When should 96369 be used instead of 96372?

Use 96369 for a medication delivered through a subcutaneous infusion. Use 96372 for a therapeutic, prophylactic, or diagnostic subcutaneous or intramuscular injection, not an infusion.

What documentation supports 96369?

Document the drug, subcutaneous route, infusion start and stop times, and establishment of the infusion site. The record should distinguish the infusion from a single injection.

Can 96369 be reported for additional infusion time?

96369 represents the initial service up to one hour. Report 96370 for qualifying additional infusion time, following the applicable CPT timing instructions.

Can 96369 be billed when staff perform the infusion?

For Medicare, the service is incident-to and may be billed only when performed under physician supervision.

Is the medication included in 96369?

96369 represents the administration service, not the medication itself. Report the drug separately when appropriate under the applicable drug billing rules.

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 96369PPRRVU2026_Oct_nonQPP.csv, line 12,783 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet