Billing code 96440: Pleural chemotherapyMedicare rate & RVUs in Alaska
Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration.
Medicare pays $845.84 for 96440 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 96440 covers
This service covers administration of an antineoplastic medication into the pleural space, with thoracentesis included as part of the procedure. It may be performed for a patient with malignant pleural disease when medication is instilled into the cavity after fluid is aspirated. The physician or other qualified practitioner accesses the pleural space, removes fluid, and administers the medication during the same service.
Report 96440 when the documented service includes pleural-cavity chemotherapy and the required thoracentesis; the aspiration is not separately reported as a second thoracentesis service. Documentation should identify the medication, route, pleural access, aspiration, and administration. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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.
96440 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $845.84 | $152.19 |
How the 96440 rate is calculated
Each of 96440’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 96440
RVUs × geographic indexes × conversion factor
Work2.12
2.12 RVUs× 1.000 GPCI
Practice expense20.72
20.72 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
22.9800
Conversion factor
$33.4009
Medicare rate
$767.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96440
The CMS indicators that decide how 96440 is paid alongside other services.
CMS payment indicators · 96440
Pleural chemotherapy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
96440 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 96446Chemotherapy administration
- Choose 96440 for chemotherapy delivered into the pleural cavity with thoracentesis; choose 96446 for delivery into the peritoneal cavity through an implanted port or catheter.
- 96450Chemotherapy administration
- 96450 covers chemotherapy administered into the central nervous system, not the pleural space.
- 96405Intralesional chemotherapy
- 96405 is for intralesional chemotherapy. 96440 is selected when the medication is administered into the pleural cavity with thoracentesis.
- 32555Thoracentesis
- 32555 describes thoracentesis with imaging guidance when drainage is the service. When pleural chemotherapy is administered with thoracentesis, 96440 includes the thoracentesis.
96440 billing questions
Can I report a separate thoracentesis with 96440?
No. Thoracentesis is included in 96440 when performed as part of the pleural-cavity chemotherapy administration. A thoracentesis without chemotherapy is a different service.
How is 96440 different from 96446?
96440 is for medication delivered into the pleural cavity with thoracentesis. 96446 is for chemotherapy delivered into the peritoneal cavity through an implanted port or catheter.
Is modifier 50 appropriate for bilateral pleural treatment?
No. CMS identifies bilateral adjustment as inappropriate for 96440. Report the service based on the documented pleural-cavity administration rather than using modifier 50.
What documentation supports 96440?
Document the antineoplastic medication, pleural route, access and aspiration of fluid, and administration into the pleural cavity. The record should show that thoracentesis was part of the chemotherapy service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is limited to cases with documented medical necessity. Co-surgeons and team surgery are not permitted for this code under the supplied CMS 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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