Billing code 96450: Chemotherapy administrationMedicare rate & RVUs in Oregon
Report this service when chemotherapy is delivered into the central nervous system, such as intrathecally, including access by spinal puncture.
Medicare pays $159.18–$172.29 for 96450 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 96450 covers
This service covers delivery of chemotherapy into the central nervous system, most commonly by an intrathecal route through a lumbar puncture. It may be performed in an oncology or hematology clinic, hospital outpatient department, or other setting where CNS-directed treatment is administered. Patients may receive it for conditions such as CNS leukemia or leptomeningeal disease. Administration through an intraventricular access device is also a CNS route.
Select this code based on the route of drug delivery, not the drug name or the diagnosis alone. Documentation should identify the medication, CNS route, access method, and completed administration. The spinal puncture used to access the treatment site is included in this service. The chemotherapy drug itself is separate from the administration service when separately reportable. 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 medical-necessity documentation; 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.
Where 96450 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $172.29 | $67.27 |
| Rest Of Oregon | $159.18 | $65.04 |
How the 96450 rate is calculated
Each of 96450’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 · 96450
RVUs × geographic indexes × conversion factor
Work1.53
1.53 RVUs× 1.000 GPCI
Practice expense3.15
3.15 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
4.8200
Conversion factor
$33.4009
Medicare rate
$160.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 96450
The CMS indicators that decide how 96450 is paid alongside other services.
CMS payment indicators · 96450
Chemotherapy administration
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| 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 | 0 | Physician service: no professional/technical split. |
96450 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 96401Chemotherapy injection
- 96450 is for CNS-directed delivery, such as intrathecal chemotherapy. 96401 is used for subcutaneous or intramuscular chemotherapy.
- 96440Pleural chemotherapy
- Choose 96450 for delivery into the central nervous system; 96440 describes chemotherapy delivered into the pleural cavity.
- 96446Chemotherapy administration
- Choose 96450 for CNS delivery; 96446 is for chemotherapy administered into the peritoneal cavity.
96450 billing questions
When should 96450 be selected instead of another chemotherapy administration code?
Use it when chemotherapy is delivered into the central nervous system, such as intrathecally or through an intraventricular access device. Select other administration codes for different routes, such as subcutaneous, intramuscular, or intravenous delivery.
Is the spinal puncture separately reported with 96450?
The puncture used to gain access for the CNS chemotherapy administration is included in this service.
Does 96450 include the chemotherapy drug?
The code represents the administration service, not the drug product. Report the drug separately when it is separately billable and supported by the claim documentation.
Can modifier 50 be used for bilateral CNS administration?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports 96450?
Record the medication, the CNS route, the access method, and that administration was completed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included.
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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