Billing code 96372: SC/IM injectionMedicare rate & RVUs in Massachusetts
Report an injection of a therapeutic, preventive, or diagnostic drug into subcutaneous tissue or muscle, such as an intramuscular ceftriaxone dose.
Medicare pays $15.88–$17.37 for 96372 in the office in Massachusetts, from Rest Of Massachusetts to Metropolitan Boston. 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 96372 covers
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.
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.
Where 96372 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $17.37 | Unavailable |
| Rest Of Massachusetts | $15.88 | Unavailable |
How the 96372 rate is calculated
Each of 96372’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 · 96372
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.17Practice expense 0.28Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96372
The CMS indicators that decide how 96372 is paid alongside other services.
CMS payment indicators · 96372
SC/IM injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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 | 5 | Incident-to service. |
96372 compared with similar codes
Compare codes
96372 vs 96374 vs 90471 vs 96402 vs 96377: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96374IV push
- This code covers injection into subcutaneous tissue or muscle; 96374 covers a drug given by IV push.
- 90471Immunization administration
- 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.
- 96402Hormonal therapy injection
- 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.
- 96377Injector application
- 96377 covers applying an on-body injector that delivers the drug later; this code covers a direct needle injection given at the visit.
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 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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