$103.25
Both involve intra-arterial chemotherapy, but 96420 is for push administration; 96422 is for infusion.
On this page
CMS RVU26D · Effective 2026-10-01
96422 Arterial infusion Medicare reimbursement rates in Vermont
Reports antineoplastic medication infused into an artery during the initial hour, such as regional chemotherapy delivered through an arterial catheter. Compare 96422 office and facility rates across CMS payment localities in Vermont.
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 96422 in Vermont?
Vermont 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
$137.81
1 of 1 localities have a supported rate.
Payment area: Vermont
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 96422: Intra-arterial chemotherapy infusion, initial hour
Reports antineoplastic medication infused into an artery during the initial hour, such as regional chemotherapy delivered through an arterial catheter.
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.
CMS billing rules for 96422
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.17 · 4%
- Practice expense (office) RVU3.96 · 94%
- Malpractice RVU0.07 · 2%
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.
96422 compared with similar codes
Office rates for Vermont, from the same CMS release.
$73.98
96422 covers the initial infusion period. Code 96423 is used for qualifying additional intra-arterial infusion time.
$130.90
96413 describes chemotherapy infusion through a vein; 96422 is for delivery into an artery.
Compare 96422 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
Vermont →
Office / nonfacility
$137.81
Facility
Unavailable
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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 96422 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
12,806
- Code
- 96422
- Physician work
- 0.17
- Practice expense
- 3.96
- Malpractice
- 0.07
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.17 | × 1.000 | 0.1700 |
| Practice expense | 3.96 | × 0.990 | 3.9204 |
| Malpractice | 0.07 | × 0.506 | 0.0354 |
| Total RVUs | 4.1258 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$137.81
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.17 | 1 |
| Practice expense | 3.96 | 0.99 |
| Malpractice | 0.07 | 0.506 |
(0.17 × 1 + 3.96 × 0.99 + 0.07 × 0.506) × $33.4009 = $137.81
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.
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 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.
12,80396416,,Chemo prolong infuse w/pump,A,,0.21,3.71,,3.71,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
12,80496417,,Chemo iv infus each addl seq,A,,0.21,1.75,,1.75,NA,0.03,1.99,1.99,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80596420,,Chemo ia push tecnique,A,,0.17,2.92,,2.92,NA,0.06,3.15,3.15,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80696422,,Chemo ia infusion up to 1 hr,A,,0.17,3.96,,3.96,NA,0.07,4.20,4.20,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80796423,,Chemo ia infuse each addl hr,A,,0.17,2.04,,2.04,NA,0.05,2.26,2.26,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80896425,,Chemotherapy infusion method,A,,0.17,4.93,,4.93,NA,0.11,5.21,5.21,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,80996440,,Chmotx admn plrl cav thrcnts,A,,2.12,20.72,,1.22,,0.14,22.98,3.48,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817