CPT code 96440: Pleural chemotherapy2026 Medicare rate & RVUs in Oklahoma

Reports antineoplastic medication delivered into the pleural cavity when thoracentesis is performed as part of the administration.

CMS RVU26DEffective Oct 1, 20261 payment locality40 Medicare services in 2024

Medicare pays $692.46 for 96440 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.

$692.46Office (non-facility)
$110.83Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 96440 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oklahoma
  2. What 96440 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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 Oklahoma

96440 office and facility rates by payment locality
Payment localityOfficeFacility
Oklahoma$692.46$110.83

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

96440 compared with similar codes

Compare codes · National

5 codes, side by side

  • 96440

    Pleural chemotherapy2.12 wRVU

    $767.55

  • 96446

    Chemotherapy administration0.37 wRVU

    $156.98−$610.57

  • 96450

    Chemotherapy administration1.53 wRVU

    $160.99−$606.56

  • 96405

    Intralesional chemotherapy0.52 wRVU

    $84.50−$683.05

  • 32555

    Thoracentesis2.21 wRVU

    $310.96−$456.59

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
RVUs for 96440PPRRVU2026_Oct_nonQPP.csv, line 12,809 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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