$142.61
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.
On this page
CMS RVU26D · Effective 2026-10-01
96440 Pleural chemotherapy Medicare reimbursement rates in Iowa
Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration. Compare 96440 office and facility rates across CMS payment localities in Iowa.
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 96440 in Iowa?
Iowa 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
$705.91
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$109.95
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
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.
Chemotherapy administration
About 96440: Pleural cavity chemotherapy administration
Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration.
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.
CMS billing rules for 96440
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.12 · 9%
- Practice expense (office) RVU20.72 · 90%
- Malpractice RVU0.14 · 1%
40
Medicare services in 2024 · #5511 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.
96440 compared with similar codes
Office rates for Iowa, from the same CMS release.
$149.23
96450 covers chemotherapy administered into the central nervous system, not the pleural space.
$78.28
96405 is for intralesional chemotherapy. 96440 is selected when the medication is administered into the pleural cavity with thoracentesis.
$287.00
32555 describes thoracentesis with imaging guidance when drainage is the service. When pleural chemotherapy is administered with thoracentesis, 96440 includes the thoracentesis.
Compare 96440 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
Iowa →
Office / nonfacility
$705.91
Facility
$109.95
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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 96440 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
12,809
- Code
- 96440
- Physician work
- 2.12
- Practice expense
- 20.72
- Malpractice
- 0.14
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.12 | × 1.000 | 2.1200 |
| Practice expense | 20.72 | × 0.915 | 18.9588 |
| Malpractice | 0.14 | × 0.397 | 0.0556 |
| Total RVUs | 21.1344 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$705.91
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.12 | 1 |
| Practice expense | 20.72 | 0.915 |
| Malpractice | 0.14 | 0.397 |
(2.12 × 1 + 20.72 × 0.915 + 0.14 × 0.397) × $33.4009 = $705.91
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.12 | 1 |
| Practice expense | 1.22 | 0.915 |
| Malpractice | 0.14 | 0.397 |
(2.12 × 1 + 1.22 × 0.915 + 0.14 × 0.397) × $33.4009 = $109.95
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.
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 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.
12,80696422,,Chemo ia infusion up to 1 hr,A,,0.17,3.96,,3.96,NA,0.07,4.20,4.20,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80796423,,Chemo ia infuse each addl hr,A,,0.17,2.04,,2.04,NA,0.05,2.26,2.26,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80896425,,Chemotherapy infusion method,A,,0.17,4.93,,4.93,NA,0.11,5.21,5.21,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80996440,,Chmotx admn plrl cav thrcnts,A,,2.12,20.72,,1.22,,0.14,22.98,3.48,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81096446,,Chemotx admn pertl cav impl,A,,0.37,4.21,,0.08,,0.12,4.70,0.57,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81196450,,Chemotherapy into cns,A,,1.53,3.15,,0.32,,0.14,4.82,1.99,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81296521,,Refill/maint portable pump,A,,0.21,4.02,,4.02,NA,0.07,4.30,4.30,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136