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CMS RVU26D · Effective 2026-10-01

96416 in Redding

Office / nonfacility

$144.20

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 96416: Prolonged IV chemotherapy pump initiation

Reports initiation of intravenous chemotherapy delivered for more than eight hours through a portable or implantable pump.

This service covers starting an intravenous chemotherapy infusion intended to continue for more than eight hours using a portable or implantable pump. It is commonly initiated by oncology staff in an office infusion clinic, with the patient continuing the infusion outside the clinic. The pump may be portable or implanted; the defining features are the prolonged infusion and pump-based delivery.

Report 96416 for starting the qualifying infusion, not for each hour the pump continues to deliver medication. Documentation should identify the chemotherapy drug, intravenous route, pump use, and infusion duration, and support that the service was initiated. The chemotherapy drug is reported separately when applicable. CMS treats this as an incident-to service: it may be billed only when performed under physician supervision.

CMS billing rules for 96416

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) RVU3.71 · 93%
  • Malpractice RVU0.07 · 2%

23K

Medicare services in 2024 · #1088 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.

96416 compared with similar codes

Office rates for Redding, from the same CMS release.

96413

Chemo IV infusion

Initial drug, first hour

$144.02

Choose 96416 for an intravenous chemotherapy infusion lasting more than eight hours through a portable or implantable pump. Code 96413 represents a shorter infusion service.

96415

Chemo infusion add-on

Each additional hour

$30.24

Code 96415 represents an additional infusion hour. Code 96416 reports initiation of a prolonged pump-based infusion, rather than successive hourly increments.

96417

Chemotherapy infusion

Additional sequential drug

$71.73

Code 96417 describes a distinct sequential infusion of another chemotherapy drug. It does not represent initiation of the prolonged pump infusion itself.

96425

Chemotherapy infusion

Prolonged intra-arterial pump

$188.22

Both codes describe prolonged pump-based chemotherapy infusion, but 96425 is for the intra-arterial route; 96416 is for intravenous administration.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 96416 is $144.38—$0.18 higher than the $144.20 rate in Redding. Both use the same code, release and participation basis.

96416 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $144.20

  2. Bakersfield

    $144.38

    $0.18 higher than Redding

  3. Chico

    $144.20

    The same base rate than Redding

  4. El Centro

    $144.21

    $0.01 higher than Redding

  5. Fresno

    $144.20

    The same base rate than Redding

  6. Hanford-Corcoran

    $144.20

    The same base rate than Redding

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

    $155.45

    $11.25 higher than Redding

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, 96416 ranges from $114.66 in Arkansas to $187.73 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

  • Madera

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Merced

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Modesto

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Napa

    California · 96416

    Office

    $171.97

    Facility

    Unavailable

    $27.77 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96416

    Office

    $155.14

    Facility

    Unavailable

    $10.94 higher than Redding for the office setting.

  • Rest Of California

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96416

    Office

    $144.95

    Facility

    Unavailable

    $0.75 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96416

    Office

    $152.64

    Facility

    Unavailable

    $8.44 higher than Redding for the office setting.

  • Salinas

    California · 96416

    Office

    $152.11

    Facility

    Unavailable

    $7.91 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96416

    Office

    $156.70

    Facility

    Unavailable

    $12.50 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96416

    Office

    $183.48

    Facility

    Unavailable

    $39.28 higher than Redding for the office setting.

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

    California · 96416

    Office

    $183.40

    Facility

    Unavailable

    $39.20 higher than Redding for the office setting.

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

    California · 96416

    Office

    $187.73

    Facility

    Unavailable

    $43.53 higher than Redding for the office setting.

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

    California · 96416

    Office

    $187.40

    Facility

    Unavailable

    $43.20 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96416

    Office

    $149.53

    Facility

    Unavailable

    $5.33 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 96416

    Office

    $158.97

    Facility

    Unavailable

    $14.77 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 96416

    Office

    $152.95

    Facility

    Unavailable

    $8.75 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 96416

    Office

    $160.65

    Facility

    Unavailable

    $16.45 higher than Redding for the office setting.

  • Stockton

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 96416

    Office

    $171.85

    Facility

    Unavailable

    $27.65 higher than Redding for the office setting.

  • Visalia

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 96416

    Office

    $144.20

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 96416

    Office

    $155.97

    Facility

    Unavailable

    $11.77 higher than Redding for the office setting.

  • Miami

    Florida · 96416

    Office

    $141.93

    Facility

    Unavailable

    $2.27 lower than Redding for the office setting.

  • Chicago

    Illinois · 96416

    Office

    $136.97

    Facility

    Unavailable

    $7.23 lower than Redding for the office setting.

  • Manhattan

    New York · 96416

    Office

    $155.16

    Facility

    Unavailable

    $10.96 higher than Redding for the office setting.

  • Alaska*

    Alaska · 96416

    Office

    $143.78

    Facility

    Unavailable

    $0.42 lower than Redding for the office setting.

  • Alabama

    Alabama · 96416

    Office

    $116.77

    Facility

    Unavailable

    $27.43 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 96416

    Office

    $114.66

    Facility

    Unavailable

    $29.54 lower than Redding for the office setting.

  • Arizona

    Arizona · 96416

    Office

    $129.09

    Facility

    Unavailable

    $15.11 lower than Redding for the office setting.

  • Colorado

    Colorado · 96416

    Office

    $140.77

    Facility

    Unavailable

    $3.43 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 96416

    Office

    $143.44

    Facility

    Unavailable

    $0.76 lower than Redding for the office setting.

  • Delaware

    Delaware · 96416

    Office

    $131.58

    Facility

    Unavailable

    $12.62 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 96416

    Office

    $136.77

    Facility

    Unavailable

    $7.43 lower than Redding for the office setting.

  • Rest Of Florida

    Florida · 96416

    Office

    $128.99

    Facility

    Unavailable

    $15.21 lower than Redding for the office setting.

  • Atlanta

    Georgia · 96416

    Office

    $135.74

    Facility

    Unavailable

    $8.46 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 96416

    Office

    $120.34

    Facility

    Unavailable

    $23.86 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 96416

    Office

    $149.26

    Facility

    Unavailable

    $5.06 higher than Redding for the office setting.

  • Iowa

    Iowa · 96416

    Office

    $121.33

    Facility

    Unavailable

    $22.87 lower than Redding for the office setting.

  • Idaho

    Idaho · 96416

    Office

    $122.12

    Facility

    Unavailable

    $22.08 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 96416

    Office

    $125.73

    Facility

    Unavailable

    $18.47 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 96416

    Office

    $123.81

    Facility

    Unavailable

    $20.39 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 96416

    Office

    $138.47

    Facility

    Unavailable

    $5.73 lower than Redding for the office setting.

  • Indiana

    Indiana · 96416

    Office

    $123.02

    Facility

    Unavailable

    $21.18 lower than Redding for the office setting.

  • Kansas

    Kansas · 96416

    Office

    $120.21

    Facility

    Unavailable

    $23.99 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 96416

    Office

    $119.32

    Facility

    Unavailable

    $24.88 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 96416

    Office

    $126.28

    Facility

    Unavailable

    $17.92 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 96416

    Office

    $118.92

    Facility

    Unavailable

    $25.28 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 96416

    Office

    $157.34

    Facility

    Unavailable

    $13.14 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96416

    Office

    $139.47

    Facility

    Unavailable

    $4.73 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96416

    Office

    $142.98

    Facility

    Unavailable

    $1.22 lower than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 96416

    Office

    $134.64

    Facility

    Unavailable

    $9.56 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 96416

    Office

    $122.47

    Facility

    Unavailable

    $21.73 lower than Redding for the office setting.

  • Southern Maine

    Maine · 96416

    Office

    $131.29

    Facility

    Unavailable

    $12.91 lower than Redding for the office setting.

  • Detroit

    Michigan · 96416

    Office

    $130.54

    Facility

    Unavailable

    $13.66 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 96416

    Office

    $122.79

    Facility

    Unavailable

    $21.41 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 96416

    Office

    $135.22

    Facility

    Unavailable

    $8.98 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 96416

    Office

    $125.66

    Facility

    Unavailable

    $18.54 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 96416

    Office

    $127.33

    Facility

    Unavailable

    $16.87 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 96416

    Office

    $116.11

    Facility

    Unavailable

    $28.09 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 96416

    Office

    $115.43

    Facility

    Unavailable

    $28.77 lower than Redding for the office setting.

  • Montana**

    Montana · 96416

    Office

    $133.26

    Facility

    Unavailable

    $10.94 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 96416

    Office

    $124.12

    Facility

    Unavailable

    $20.08 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 96416

    Office

    $131.88

    Facility

    Unavailable

    $12.32 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 96416

    Office

    $122.27

    Facility

    Unavailable

    $21.93 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 96416

    Office

    $138.06

    Facility

    Unavailable

    $6.14 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 96416

    Office

    $153.70

    Facility

    Unavailable

    $9.50 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 96416

    Office

    $145.18

    Facility

    Unavailable

    $0.98 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 96416

    Office

    $123.45

    Facility

    Unavailable

    $20.75 lower than Redding for the office setting.

  • Nevada**

    Nevada · 96416

    Office

    $133.00

    Facility

    Unavailable

    $11.20 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96416

    Office

    $159.14

    Facility

    Unavailable

    $14.94 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96416

    Office

    $145.85

    Facility

    Unavailable

    $1.65 higher than Redding for the office setting.

  • Queens

    New York · 96416

    Office

    $157.30

    Facility

    Unavailable

    $13.10 higher than Redding for the office setting.

  • Rest Of New York

    New York · 96416

    Office

    $126.38

    Facility

    Unavailable

    $17.82 lower than Redding for the office setting.

  • Ohio

    Ohio · 96416

    Office

    $122.51

    Facility

    Unavailable

    $21.69 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 96416

    Office

    $119.49

    Facility

    Unavailable

    $24.71 lower than Redding for the office setting.

  • Portland

    Oregon · 96416

    Office

    $146.54

    Facility

    Unavailable

    $2.34 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 96416

    Office

    $132.08

    Facility

    Unavailable

    $12.12 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96416

    Office

    $138.93

    Facility

    Unavailable

    $5.27 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96416

    Office

    $122.98

    Facility

    Unavailable

    $21.22 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 96416

    Office

    $134.60

    Facility

    Unavailable

    $9.60 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 96416

    Office

    $137.24

    Facility

    Unavailable

    $6.96 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 96416

    Office

    $123.50

    Facility

    Unavailable

    $20.70 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 96416

    Office

    $131.72

    Facility

    Unavailable

    $12.48 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 96416

    Office

    $120.91

    Facility

    Unavailable

    $23.29 lower than Redding for the office setting.

  • Austin

    Texas · 96416

    Office

    $140.20

    Facility

    Unavailable

    $4.00 lower than Redding for the office setting.

  • Beaumont

    Texas · 96416

    Office

    $121.95

    Facility

    Unavailable

    $22.25 lower than Redding for the office setting.

  • Brazoria

    Texas · 96416

    Office

    $131.70

    Facility

    Unavailable

    $12.50 lower than Redding for the office setting.

  • Dallas

    Texas · 96416

    Office

    $132.51

    Facility

    Unavailable

    $11.69 lower than Redding for the office setting.

  • Fort Worth

    Texas · 96416

    Office

    $131.30

    Facility

    Unavailable

    $12.90 lower than Redding for the office setting.

  • Galveston

    Texas · 96416

    Office

    $132.06

    Facility

    Unavailable

    $12.14 lower than Redding for the office setting.

  • Houston

    Texas · 96416

    Office

    $133.34

    Facility

    Unavailable

    $10.86 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 96416

    Office

    $126.72

    Facility

    Unavailable

    $17.48 lower than Redding for the office setting.

  • Utah

    Utah · 96416

    Office

    $125.60

    Facility

    Unavailable

    $18.60 lower than Redding for the office setting.

  • Virginia

    Virginia · 96416

    Office

    $130.48

    Facility

    Unavailable

    $13.72 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96416

    Office

    $134.60

    Facility

    Unavailable

    $9.60 lower than Redding for the office setting.

  • Vermont

    Vermont · 96416

    Office

    $130.88

    Facility

    Unavailable

    $13.32 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 96416

    Office

    $139.37

    Facility

    Unavailable

    $4.83 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 96416

    Office

    $161.32

    Facility

    Unavailable

    $17.12 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 96416

    Office

    $126.45

    Facility

    Unavailable

    $17.75 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 96416

    Office

    $118.04

    Facility

    Unavailable

    $26.16 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 96416

    Office

    $132.66

    Facility

    Unavailable

    $11.54 lower than Redding for the office setting.

See how rates vary across the country

96416 · 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.

$114.66

$165.96

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$143.781
AL$116.771
AR$114.661
AZ$129.091
CA$144.20–$187.7329
CO$140.771
CT$143.441
DC$155.971
DE$131.581
FL$128.99–$141.933
GA$120.34–$135.742
GU$149.261
HI$149.261
IA$121.331
ID$122.121
IL$123.81–$138.474
IN$123.021
KS$120.211
KY$119.321
LA$118.92–$126.282
MA$139.47–$157.342
MD$134.64–$155.973
ME$122.47–$131.292
MI$122.79–$130.542
MN$135.221
MO$116.11–$127.333
MS$115.431
MT$133.261
NC$124.121
ND$131.881
NE$122.271
NH$138.061
NJ$145.18–$153.702
NM$123.451
NV$133.001
NY$126.38–$159.145
OH$122.511
OK$119.491
OR$132.08–$146.542
PA$122.98–$138.932
PR$134.601
RI$137.241
SC$123.501
SD$131.721
TN$120.911
TX$121.95–$140.208
UT$125.601
VA$130.48–$155.972
VI$134.601
VT$130.881
WA$139.37–$161.322
WI$126.451
WV$118.041
WY$132.661

Explore 96416 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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 96416 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$158.62

$144.20 × 110% = $158.62

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 96416 in Redding.

PPRRVU2026_Oct_nonQPP.csv

12,803

Code
96416
Physician work
0.21
Practice expense
3.71
Malpractice
0.07

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 96416 in Redding
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0170.2136
Practice expense3.71× 1.0964.0662
Malpractice0.07× 0.5360.0375
Total RVUs4.3172
Conversion factor× 33.4009

Office / nonfacility rate, Redding$144.20

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

Open 96416 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.211.017
Practice expense3.711.096
Malpractice0.070.536

(0.21 × 1.017 + 3.71 × 1.096 + 0.07 × 0.536) × $33.4009 = $144.20

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

96416 · Office / nonfacility

$144.20

Effective 2026-10-01

The base rate is $17.26 higher than on 2025-10-01, moving from $126.94 to $144.20 (13.6%).

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

    $126.94changed to$144.20

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.37 changed to 3.71
    • Malpractice RVU 0.05 changed to 0.07
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $126.94

    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$144.20Not available in this settingRVU26D
2026-07-01$144.20Not available in this settingRVU26C
2026-04-01$144.20Not available in this settingRVU26B
2026-01-01$144.20Not available in this settingRVU26A
2025-10-01$126.94Not available in this settingRVU25D
2025-07-01$126.94Not available in this settingRVU25C
2025-04-01$126.94Not available in this settingRVU25B
2025-01-01$126.94Not available in this settingRVU25A

96416 billing questions

When should 96416 be used instead of 96413?

Use 96416 when intravenous chemotherapy is initiated for an infusion lasting more than eight hours through a portable or implantable pump. Code 96413 describes a shorter intravenous infusion service.

Is 96416 reported for every hour of pump delivery?

No. It reports initiation of the prolonged pump infusion, not repeated hourly increments.

Is the chemotherapy drug included in 96416?

The code reports the administration service. Report the chemotherapy drug separately when applicable.

What documentation supports 96416?

Document the drug, intravenous route, use of a portable or implantable pump, infusion duration, and initiation of the infusion.

What supervision is required for Medicare billing?

CMS identifies 96416 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 96416PPRRVU2026_Oct_nonQPP.csv, line 12,803 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet