Billing code 96422: Arterial infusionMedicare rate & RVUs in Oregon
Reports antineoplastic medication infused into an artery during the initial hour, such as regional chemotherapy delivered through an arterial catheter.
Medicare pays $139.06–$154.46 for 96422 in the office in Oregon, from Rest Of Oregon to Portland. 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 96422 covers
Code 96422 represents chemotherapy delivered by infusion into an artery. Oncology clinicians may use this approach for regional treatment, such as delivering chemotherapy through a catheter positioned in the hepatic artery for liver-directed therapy. The code concerns the medication administration, not placement of the arterial catheter. It is distinct from an arterial injection and from infusion through a vein.
Select this code when the antineoplastic agent is infused intra-arterially and the administration fits the code’s first-hour scope. The medication may be reported separately when applicable; consider 96423 for qualifying additional infusion time. Document the agent, arterial route, and infusion start and stop times in the treatment record. Under the CMS incident-to rule supplied for this code, Medicare billing requires that the service be performed under physician supervision.
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 96422 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $154.46 | Unavailable |
| Rest Of Oregon | $139.06 | Unavailable |
How the 96422 rate is calculated
Each of 96422’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 · 96422
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.17Practice expense 3.96Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96422
The CMS indicators that decide how 96422 is paid alongside other services.
CMS payment indicators · 96422
Arterial infusion
| 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. |
96422 compared with similar codes
Compare codes
96422 vs 96420 vs 96423 vs 96413: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96420Chemotherapy push
- Both involve intra-arterial chemotherapy, but 96420 is for push administration; 96422 is for infusion.
- 96423Chemotherapy infusion
- 96422 covers the initial infusion period. Code 96423 is used for qualifying additional intra-arterial infusion time.
- 96413Chemo IV infusion
- 96413 describes chemotherapy infusion through a vein; 96422 is for delivery into an artery.
96422 billing questions
When is 96422 used instead of 96420?
Use 96422 for chemotherapy administered by intra-arterial infusion. Code 96420 describes intra-arterial delivery by push technique.
Can the chemotherapy drug be billed separately?
The administration code reports the infusion service, not the medication supply. Report the drug separately when applicable.
When might 96423 be reported with 96422?
Code 96423 is the additional-hour code for intra-arterial chemotherapy infusion. The documented infusion duration must support reporting additional time.
What documentation supports 96422?
Record the antineoplastic agent, intra-arterial route, and infusion start and stop times in the treatment record.
What supervision is required for Medicare billing?
Under the CMS incident-to rule for this code, the service must be performed under physician supervision for Medicare billing.
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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