$54.05
96409 represents the single or initial drug given by IV push. 96411 represents an additional chemotherapy drug administered by IV push.
On this page
CMS RVU26D · Effective 2026-10-01
96409 Chemotherapy push Medicare reimbursement rates in Utah
Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug. Compare 96409 office and facility rates across CMS payment localities in Utah.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 96409 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$98.67
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Chemotherapy administration
About 96409: Single-drug intravenous chemotherapy push
Report this service when an antineoplastic drug is administered through a vein by push as the only or initial chemotherapy drug.
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.
CMS billing rules for 96409
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.24 · 8%
- Practice expense (office) RVU2.83 · 90%
- Malpractice RVU0.06 · 2%
37.4K
Medicare services in 2024 · #893 by national volume
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.
96409 compared with similar codes
Office rates for Utah, from the same CMS release.
$125.74
Choose 96409 for administration by IV push; choose 96413 when the drug is delivered by IV infusion over time.
$67.87
96401 is for chemotherapy given subcutaneously or intramuscularly. 96409 is for chemotherapy delivered through venous access by IV push.
Compare 96409 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Utah →
Office / nonfacility
$98.67
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 96409 in Utah.
PPRRVU2026_Oct_nonQPP.csv
12,799
- Code
- 96409
- Physician work
- 0.24
- Practice expense
- 2.83
- Malpractice
- 0.06
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.24 | × 1.000 | 0.2400 |
| Practice expense | 2.83 | × 0.940 | 2.6602 |
| Malpractice | 0.06 | × 0.898 | 0.0539 |
| Total RVUs | 2.9541 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$98.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.24 | 1 |
| Practice expense | 2.83 | 0.94 |
| Malpractice | 0.06 | 0.898 |
(0.24 × 1 + 2.83 × 0.94 + 0.06 × 0.898) × $33.4009 = $98.67
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,79696402,,Chemo hormon antineopl sq/im,A,,0.19,0.95,,0.95,NA,0.02,1.16,1.16,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79796405,,Chemo intralesional up to 7,A,,0.52,1.98,,0.16,,0.03,2.53,0.71,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79896406,,Chemo intralesional over 7,A,,0.80,3.09,,0.26,,0.06,3.95,1.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79996409,,Chemo iv push sngl drug,A,,0.24,2.83,,2.83,NA,0.06,3.13,3.13,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80096411,,Chemo iv push addl drug,A,,0.20,1.48,,1.48,NA,0.03,1.71,1.71,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80196413,,Chemo iv infusion 1 hr,A,,0.28,3.64,,3.64,NA,0.07,3.99,3.99,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80296415,,Chemo iv infusion addl hr,A,,0.19,0.64,,0.64,NA,0.02,0.85,0.85,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985