Billing code 96409: Chemotherapy pushMedicare rate & RVUs in Texas
Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug.
Medicare pays $95.90–$109.81 for 96409 in the office in Texas, from Beaumont to Austin. 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 96409 covers
This service covers administration of an antineoplastic drug through venous access by a brief intravenous push, rather than by a timed infusion. It is commonly performed by oncology nursing staff in an office or outpatient cancer clinic. The code represents one drug administered by this method; the drug itself is generally reported separately when separately payable and supported by the record.
Select this code when the documented route and method are intravenous push and the service is for a single or initial drug. The medication administration record should identify the drug, dose, route, and administration method; document additional drugs and their sequence when applicable. An additional chemotherapy drug given by IV push may be reported with 96411. For Medicare, this is an incident-to service and is billed only when 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 96409 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$95.90 to $109.81
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $109.81 | Unavailable |
| Beaumont | $95.90 | Unavailable |
| Brazoria | $103.32 | Unavailable |
| Dallas | $103.95 | Unavailable |
| Fort Worth | $103.04 | Unavailable |
| Galveston | $103.60 | Unavailable |
| Houston | $104.70 | Unavailable |
| Rest Of Texas | $99.53 | Unavailable |
How the 96409 rate is calculated
Each of 96409’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 · 96409
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.24Practice expense 2.83Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 96409
The CMS indicators that decide how 96409 is paid alongside other services.
CMS payment indicators · 96409
Chemotherapy push
| 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. |
96409 compared with similar codes
Compare codes
96409 vs 96411 vs 96413 vs 96401: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 96411IV chemotherapy push
- 96409 represents the single or initial drug given by IV push. 96411 represents an additional chemotherapy drug administered by IV push.
- 96413Chemo IV infusion
- Choose 96409 for administration by IV push; choose 96413 when the drug is delivered by IV infusion over time.
- 96401Chemotherapy injection
- 96401 is for chemotherapy given subcutaneously or intramuscularly. 96409 is for chemotherapy delivered through venous access by IV push.
96409 billing questions
When should 96409 be used instead of 96411?
Use 96409 for the single or initial chemotherapy drug given by IV push. Report 96411 for an additional chemotherapy drug administered by IV push in the same treatment.
How does 96409 differ from 96413?
96409 describes a brief IV push. Use 96413 when the chemotherapy is administered by IV infusion over time, rather than by push.
Is the chemotherapy drug included in 96409?
The code represents the administration service, not the drug supply. Report the drug separately when it is separately payable and the record supports it.
What documentation supports 96409?
The medication administration record should identify the antineoplastic drug, dose, IV route, and push method. Record any additional drugs and their sequence to support use of 96411 when applicable.
What Medicare supervision condition applies?
Medicare treats 96409 as an incident-to service. It may be billed only when performed under physician supervision.
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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