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CMS RVU26D · Effective 2026-10-01

96405 in Wyoming**

Office / nonfacility

$84.24

Base rate per service

Facility setting

$23.45

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 96405: Intralesional chemotherapy for up to seven lesions

Report 96405 when an antineoplastic drug is administered directly into one to seven lesions, such as in a dermatology or oncology setting.

A physician or other qualified practitioner reports 96405 for administering chemotherapy directly into one or more lesions, with the code covering up to seven lesions. This is a local injection into the lesions, rather than systemic chemotherapy given subcutaneously, intramuscularly, or intravenously. Dermatology and oncology practices commonly provide this service for selected cutaneous lesions; the code represents the administration, not the drug product.

Document the antineoplastic agent, intralesional route, treated sites, and lesion count. Use the code for one through seven lesions; when more than seven are treated, compare the service with 96406. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 96405

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU0.52 · 21%
  • Practice expense (office) RVU1.98 · 78%
  • Malpractice RVU0.03 · 1%

30.7K

Medicare services in 2024 · #969 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.

96405 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

96406

Intralesional chemotherapy

More than seven lesions

$131.41

Both codes cover intralesional chemotherapy. Select 96405 for one through seven lesions and 96406 when more than seven lesions are treated.

11900

Lesion injection

Up to seven lesions

$56.35

Use 96405 for intralesional chemotherapy; 11900 describes intralesional injection of a nonchemotherapy substance for up to seven lesions.

11901

Lesion injection

More than seven lesions

$68.20

Use 96405 for chemotherapy into up to seven lesions. Code 11901 is for nonchemotherapy intralesional injection when more than seven lesions are treated.

96401

Chemotherapy injection

Subcutaneous or intramuscular, nonhormonal

$71.46

Both involve chemotherapy administration, but 96401 is for subcutaneous or intramuscular delivery; 96405 is for injection directly into lesions.

The same code, a different location

How does Wyoming** compare?

96405 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $84.24

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

    $96.98

    $12.74 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $97.33

    $13.09 higher than Wyoming**

  4. Miami

    $88.75

    $4.51 higher than Wyoming**

  5. Chicago

    $86.25

    $2.01 higher than Wyoming**

  6. Manhattan

    $96.92

    $12.68 higher than Wyoming**

  7. Alaska*

    $97.04

    $12.80 higher than Wyoming**

Other payment areas listed in Wyoming 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, 96405 ranges from $74.69 in Arkansas to $115.18 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

  • Alabama

    Alabama · 96405

    Office

    $75.80

    Facility

    $22.61

    $8.44 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 96405

    Office

    $74.69

    Facility

    $22.48

    $9.55 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 96405

    Office

    $82.31

    Facility

    $23.40

    $1.93 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 96405

    Office

    $90.79

    Facility

    $24.17

    $6.55 higher than Wyoming** for the office setting.

  • Chico

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • El Centro

    California · 96405

    Office

    $90.69

    Facility

    $24.06

    $6.45 higher than Wyoming** for the office setting.

  • Fresno

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Madera

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Merced

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Modesto

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Napa

    California · 96405

    Office

    $106.14

    Facility

    $26.02

    $21.90 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 96405

    Office

    $96.65

    Facility

    $24.80

    $12.41 higher than Wyoming** for the office setting.

  • Redding

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 96405

    Office

    $91.02

    Facility

    $24.39

    $6.78 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 96405

    Office

    $95.44

    Facility

    $24.75

    $11.20 higher than Wyoming** for the office setting.

  • Salinas

    California · 96405

    Office

    $95.09

    Facility

    $24.64

    $10.85 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 96405

    Office

    $97.53

    Facility

    $24.82

    $13.29 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 96405

    Office

    $112.73

    Facility

    $27.01

    $28.49 higher than Wyoming** for the office setting.

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

    California · 96405

    Office

    $112.69

    Facility

    $26.98

    $28.45 higher than Wyoming** for the office setting.

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

    California · 96405

    Office

    $115.18

    Facility

    $27.52

    $30.94 higher than Wyoming** for the office setting.

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

    California · 96405

    Office

    $115.04

    Facility

    $27.38

    $30.80 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 96405

    Office

    $93.53

    Facility

    $24.29

    $9.29 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 96405

    Office

    $98.62

    Facility

    $24.76

    $14.38 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 96405

    Office

    $95.50

    Facility

    $24.62

    $11.26 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 96405

    Office

    $99.64

    Facility

    $24.99

    $15.40 higher than Wyoming** for the office setting.

  • Stockton

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Vallejo

    California · 96405

    Office

    $106.09

    Facility

    $25.97

    $21.85 higher than Wyoming** for the office setting.

  • Visalia

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Yuba City

    California · 96405

    Office

    $90.68

    Facility

    $24.06

    $6.44 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 96405

    Office

    $88.73

    Facility

    $24.05

    $4.49 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 96405

    Office

    $90.15

    Facility

    $24.68

    $5.91 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 96405

    Office

    $83.70

    Facility

    $23.64

    $0.54 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 96405

    Office

    $86.17

    Facility

    $24.59

    $1.93 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 96405

    Office

    $82.10

    Facility

    $23.98

    $2.14 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 96405

    Office

    $85.82

    Facility

    $24.05

    $1.58 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 96405

    Office

    $77.55

    Facility

    $23.33

    $6.69 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 96405

    Office

    $93.14

    Facility

    $24.02

    $8.90 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 96405

    Office

    $78.28

    Facility

    $22.66

    $5.96 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 96405

    Office

    $78.69

    Facility

    $22.76

    $5.55 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 96405

    Office

    $80.23

    Facility

    $24.30

    $4.01 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 96405

    Office

    $79.31

    Facility

    $23.81

    $4.93 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 96405

    Office

    $87.19

    Facility

    $24.75

    $2.95 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 96405

    Office

    $79.16

    Facility

    $22.81

    $5.08 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 96405

    Office

    $77.66

    Facility

    $22.70

    $6.58 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 96405

    Office

    $77.08

    Facility

    $23.04

    $7.16 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 96405

    Office

    $80.74

    Facility

    $23.54

    $3.50 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 96405

    Office

    $76.86

    Facility

    $23.06

    $7.38 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 96405

    Office

    $97.94

    Facility

    $25.35

    $13.70 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 96405

    Office

    $88.08

    Facility

    $24.07

    $3.84 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 96405

    Office

    $89.85

    Facility

    $24.62

    $5.61 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 96405

    Office

    $85.39

    Facility

    $23.87

    $1.15 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 96405

    Office

    $78.83

    Facility

    $22.91

    $5.41 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 96405

    Office

    $83.54

    Facility

    $23.30

    $0.70 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 96405

    Office

    $82.88

    Facility

    $24.21

    $1.36 lower than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 96405

    Office

    $78.88

    Facility

    $23.38

    $5.36 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 96405

    Office

    $85.72

    Facility

    $23.16

    $1.48 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 96405

    Office

    $80.45

    Facility

    $23.37

    $3.79 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 96405

    Office

    $81.33

    Facility

    $23.46

    $2.91 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 96405

    Office

    $75.35

    Facility

    $22.95

    $8.89 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 96405

    Office

    $75.05

    Facility

    $22.71

    $9.19 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 96405

    Office

    $84.50

    Facility

    $23.71

    $0.26 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 96405

    Office

    $79.71

    Facility

    $22.99

    $4.53 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 96405

    Office

    $83.91

    Facility

    $23.12

    $0.33 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 96405

    Office

    $78.79

    Facility

    $22.68

    $5.45 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 96405

    Office

    $87.09

    Facility

    $23.81

    $2.85 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 96405

    Office

    $96.25

    Facility

    $25.73

    $12.01 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 96405

    Office

    $91.38

    Facility

    $25.00

    $7.14 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 96405

    Office

    $79.22

    Facility

    $23.47

    $5.02 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 96405

    Office

    $84.40

    Facility

    $23.55

    $0.16 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 96405

    Office

    $98.97

    Facility

    $26.70

    $14.73 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 96405

    Office

    $91.78

    Facility

    $25.21

    $7.54 higher than Wyoming** for the office setting.

  • Queens

    New York · 96405

    Office

    $98.10

    Facility

    $26.24

    $13.86 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 96405

    Office

    $80.90

    Facility

    $23.15

    $3.34 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 96405

    Office

    $78.76

    Facility

    $23.26

    $5.48 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 96405

    Office

    $77.20

    Facility

    $22.92

    $7.04 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 96405

    Office

    $91.87

    Facility

    $24.33

    $7.63 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 96405

    Office

    $83.94

    Facility

    $23.40

    $0.30 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 96405

    Office

    $87.72

    Facility

    $24.44

    $3.48 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 96405

    Office

    $79.03

    Facility

    $23.22

    $5.21 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 96405

    Office

    $85.22

    Facility

    $23.76

    $0.98 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 96405

    Office

    $86.91

    Facility

    $24.11

    $2.67 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 96405

    Office

    $79.33

    Facility

    $23.16

    $4.91 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 96405

    Office

    $83.84

    Facility

    $23.05

    $0.40 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 96405

    Office

    $78.02

    Facility

    $22.76

    $6.22 lower than Wyoming** for the office setting.

  • Austin

    Texas · 96405

    Office

    $88.26

    Facility

    $23.95

    $4.02 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 96405

    Office

    $78.48

    Facility

    $23.16

    $5.76 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 96405

    Office

    $83.83

    Facility

    $23.59

    $0.41 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 96405

    Office

    $84.25

    Facility

    $23.71

    $0.01 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 96405

    Office

    $83.61

    Facility

    $23.67

    $0.63 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 96405

    Office

    $84.01

    Facility

    $23.64

    $0.23 lower than Wyoming** for the office setting.

  • Houston

    Texas · 96405

    Office

    $84.56

    Facility

    $24.19

    $0.32 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 96405

    Office

    $81.03

    Facility

    $23.34

    $3.21 lower than Wyoming** for the office setting.

  • Utah

    Utah · 96405

    Office

    $80.43

    Facility

    $23.29

    $3.81 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 96405

    Office

    $83.09

    Facility

    $23.33

    $1.15 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 96405

    Office

    $85.22

    Facility

    $23.76

    $0.98 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 96405

    Office

    $83.35

    Facility

    $23.17

    $0.89 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 96405

    Office

    $88.00

    Facility

    $23.98

    $3.76 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 96405

    Office

    $100.20

    Facility

    $25.61

    $15.96 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 96405

    Office

    $81.03

    Facility

    $22.80

    $3.21 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 96405

    Office

    $76.27

    Facility

    $23.45

    $7.97 lower than Wyoming** for the office setting.

See how rates vary across the country

96405 · 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.

$74.69

$102.93

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$97.041
AL$75.801
AR$74.691
AZ$82.311
CA$90.68–$115.1829
CO$88.731
CT$90.151
DC$97.331
DE$83.701
FL$82.10–$88.753
GA$77.55–$85.822
GU$93.141
HI$93.141
IA$78.281
ID$78.691
IL$79.31–$87.194
IN$79.161
KS$77.661
KY$77.081
LA$76.86–$80.742
MA$88.08–$97.942
MD$85.39–$97.333
ME$78.83–$83.542
MI$78.88–$82.882
MN$85.721
MO$75.35–$81.333
MS$75.051
MT$84.501
NC$79.711
ND$83.911
NE$78.791
NH$87.091
NJ$91.38–$96.252
NM$79.221
NV$84.401
NY$80.90–$98.975
OH$78.761
OK$77.201
OR$83.94–$91.872
PA$79.03–$87.722
PR$85.221
RI$86.911
SC$79.331
SD$83.841
TN$78.021
TX$78.48–$88.268
UT$80.431
VA$83.09–$97.332
VI$85.221
VT$83.351
WA$88.00–$100.202
WI$81.031
WV$76.271
WY$84.241

Explore 96405 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 96405 in Wyoming**, the physician’s office rate is $84.24 and the facility-setting rate is $23.45: a difference of $60.79.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 96405 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$92.66

$84.24 × 110% = $92.66

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 96405 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

12,797

Code
96405
Physician work
0.52
Practice expense
1.98
Malpractice
0.03

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 96405 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work0.52× 1.0000.5200
Practice expense1.98× 1.0001.9800
Malpractice0.03× 0.7400.0222
Total RVUs2.5222
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$84.24

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

Open 96405 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.521
Practice expense1.981
Malpractice0.030.74

(0.52 × 1 + 1.98 × 1 + 0.03 × 0.74) × $33.4009 = $84.24

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.521
Practice expense0.161
Malpractice0.030.74

(0.52 × 1 + 0.16 × 1 + 0.03 × 0.74) × $33.4009 = $23.45

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

96405 · Office / nonfacility

$84.24

Effective 2026-10-01

The base rate is $4.92 higher than on 2025-10-01, moving from $79.32 to $84.24 (6.2%).

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

    $79.32changed to$84.24

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.91 changed to 1.98
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $79.32

    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$84.24$23.45RVU26D
2026-07-01$84.24$23.45RVU26C
2026-04-01$84.24$23.45RVU26B
2026-01-01$84.24$23.45RVU26A
2025-10-01$79.32$27.56RVU25D
2025-07-01$79.32$27.56RVU25C
2025-04-01$79.32$27.56RVU25B
2025-01-01$79.32$27.56RVU25A

96405 billing questions

How many lesions can be reported with 96405?

96405 covers administration into one through seven lesions. For treatment of more than seven lesions, compare the service with 96406 rather than reporting 96405 for every lesion.

How is 96405 different from 11900?

96405 is for intralesional chemotherapy. Code 11900 is for intralesional injection of a substance other than chemotherapy, for up to seven lesions.

Is the chemotherapy drug included in 96405?

No. The code represents administration; report a separately payable drug product under its applicable code when the practice supplies it and documentation supports separate reporting.

Should modifier 50 be used when lesions are on both sides?

No. CMS identifies bilateral adjustment as inappropriate for 96405. Report the service based on the number of treated lesions, not as a bilateral procedure.

What documentation supports 96405?

Record the drug, intralesional route, lesion locations, and number of lesions treated. The count supports choosing 96405 for up to seven lesions or 96406 for more than seven.

How does CMS handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction. CMS does not pay an assistant at surgery for 96405.

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 96405PPRRVU2026_Oct_nonQPP.csv, line 12,797 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet