$39.66
This code covers injection into subcutaneous tissue or muscle; 96374 covers a drug given by IV push.
On this page
CMS RVU26D · Effective 2026-10-01
96372 SC/IM injection Medicare reimbursement rates in Colorado
Report an injection of a therapeutic, preventive, or diagnostic drug into subcutaneous tissue or muscle, such as an intramuscular ceftriaxone dose. Compare 96372 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for 96372 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$15.96
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Drug administration
About 96372: Subcutaneous or intramuscular drug injection
Report an injection of a therapeutic, preventive, or diagnostic drug into subcutaneous tissue or muscle, such as an intramuscular ceftriaxone dose.
This service involves giving a drug by needle into subcutaneous tissue or muscle for treatment, prevention, or diagnosis. Examples include intramuscular ceftriaxone, ketorolac for acute pain, vitamin B12, and medroxyprogesterone for contraception. Nurses or medical assistants commonly give these injections in physician offices, urgent care centers, and clinics. The service includes preparing the drug, selecting the site, administering the injection, and brief observation.
Report one unit for each separate injection, not for each unit of drug supplied. When the practice supplies a separately billable drug, report its appropriate HCPCS code, such as J3420 for vitamin B12 or J0696 for ceftriaxone. Document the drug, dose, route, site, administrator, and any distinct injections supporting multiple units. CMS identifies this as an incident-to service billed only when performed under physician supervision. Vaccine, allergen immunotherapy, and antineoplastic drug injections have separate administration codes; a local anesthetic injection integral to another procedure is included in that procedure.
CMS billing rules for 96372
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.17 · 37%
- Practice expense (office) RVU0.28 · 61%
- Malpractice RVU0.01 · 2%
6.9M
Medicare services in 2024 · #28 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.
96372 compared with similar codes
Office rates for Colorado, from the same CMS release.
$23.07
Use a vaccine administration code such as 90471 when applicable, rather than this code. Medicare-covered influenza, pneumococcal, and hepatitis B vaccines have specific administration G codes.
$40.71
Choose 96402 for SC or IM administration of a hormonal antineoplastic drug such as leuprolide for prostate cancer. A non-antineoplastic hormone injection, such as medroxyprogesterone for contraception, uses this code.
$19.87
96377 covers applying an on-body injector that delivers the drug later; this code covers a direct needle injection given at the visit.
Compare 96372 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$15.96
Facility
Unavailable
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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 96372 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
12,786
- Code
- 96372
- Physician work
- 0.17
- Practice expense
- 0.28
- Malpractice
- 0.01
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.17 | × 1.012 | 0.1720 |
| Practice expense | 0.28 | × 1.064 | 0.2979 |
| Malpractice | 0.01 | × 0.781 | 0.0078 |
| Total RVUs | 0.4778 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$15.96
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.17 | 1.012 |
| Practice expense | 0.28 | 1.064 |
| Malpractice | 0.01 | 0.781 |
(0.17 × 1.012 + 0.28 × 1.064 + 0.01 × 0.781) × $33.4009 = $15.96
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.
96372 billing questions
Can an E/M visit be billed on the same day as this injection?
Yes, if the provider performs a significant, separately identifiable E/M service, append modifier 25 to the E/M code. Do not report 99211 with the drug administration service.
How are two injections given at the same visit reported?
Report one unit for each separate injection and document each drug, dose, route, and site. Do not count drug supply units as injection units or append modifier 59 or XU solely because two injections occurred.
Is this code used for flu shots or other vaccines?
No. Vaccine administration uses immunization codes, such as 90471 or 90472 when applicable. Medicare uses G0008 for influenza, G0009 for pneumococcal, and G0010 for hepatitis B vaccine administration.
What supervision is required for Medicare to pay it in the office?
CMS identifies this as an incident-to service billed only when performed under physician supervision. Document who administered the injection and the supervision arrangement when office staff perform it.
Should a testosterone or denosumab injection be billed here or with a chemotherapy administration code?
Use this code for subcutaneous or intramuscular administration of non-antineoplastic drugs such as testosterone cypionate or denosumab. Use 96402 for subcutaneous or intramuscular administration of a hormonal antineoplastic agent such as leuprolide for prostate cancer.
Is a local anesthetic injection before a procedure reported with this code?
No. Local anesthesia given as part of a laceration repair or lesion excision is included in that procedure rather than reported as a separate drug administration service.
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.
12,78396369,,Sc ther infusion up to 1 hr,A,,0.21,4.10,,4.10,NA,0.03,4.34,4.34,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78496370,,Sc ther infusion addl hr,A,,0.18,0.32,,0.32,NA,0.01,0.51,0.51,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78596371,,Sc ther infusion reset pump,A,,0.00,1.69,,1.69,NA,0.00,1.69,1.69,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78696372,,Ther/proph/diag inj sc/im,A,,0.17,0.28,,0.28,NA,0.01,0.46,0.46,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78796373,,Ther/proph/diag inj ia,A,,0.17,0.41,,0.41,NA,0.01,0.59,0.59,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78896374,,Ther/proph/diag inj iv push,A,,0.18,0.93,,0.93,NA,0.02,1.13,1.13,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78996375,,Tx/pro/dx inj new drug addon,A,,0.10,0.36,,0.36,NA,0.01,0.47,0.47,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899