$35.98
96374 identifies an initial therapeutic IV push selected under the drug-administration hierarchy. Use 96375 for an additional sequential push of a different drug.
On this page
CMS RVU26D · Effective 2026-10-01
96375 IV push add-on Medicare reimbursement rates in Wisconsin
Report 96375 for each additional sequential IV push of a different therapeutic, prophylactic, or diagnostic drug after a qualifying initial administration. Compare 96375 office and facility rates across CMS payment localities in Wisconsin.
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 96375 in Wisconsin?
Wisconsin 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
$14.96
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Drug administration
About 96375: Each additional sequential IV push, new drug
Report 96375 for each additional sequential IV push of a different therapeutic, prophylactic, or diagnostic drug after a qualifying initial administration.
This add-on captures a subsequent IV push of a different therapeutic, prophylactic, or diagnostic drug during the encounter. An IV push may be an injection administered and observed by a clinician throughout, or an administration lasting 15 minutes or less. In an oncology office or infusion suite, for example, a nurse might push ondansetron and then dexamethasone as separate supportive medications under physician supervision.
Report one unit for each different drug given by sequential IV push after a qualifying initial administration, such as an initial therapeutic infusion or IV push. A nonchemotherapy push may also follow an initial chemotherapy administration. Select the initial service under the drug-administration hierarchy rather than by the order in which drugs were given. Record each drug, route, administration time, and administering clinician. As an add-on, 96375 is billed with a primary procedure and paid within that procedure’s global period. Medicare treats it as an incident-to service billed only when performed under physician supervision. Report separately billable drug supplies with the appropriate drug codes.
CMS billing rules for 96375
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.10 · 21%
- Practice expense (office) RVU0.36 · 77%
- Malpractice RVU0.01 · 2%
1.4M
Medicare services in 2024 · #115 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.
96375 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
96376
No office rateTx/pro/dx inj same drug adon
96376 describes a repeat push of the same drug more than 30 minutes after the prior push, for facility reporting. Code 96375 requires a different drug.
$28.53
Choose 96367 when an additional new drug is given by sequential IV infusion for more than 15 minutes. Use 96375 for a sequential IV push or an administration lasting 15 minutes or less.
$14.74
96372 describes a subcutaneous or intramuscular injection. Code 96375 requires an additional sequential IV push after a qualifying initial administration.
Compare 96375 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
Wisconsin →
Office / nonfacility
$14.96
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 96375 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
12,789
- Code
- 96375
- Physician work
- 0.10
- Practice expense
- 0.36
- Malpractice
- 0.01
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.10 | × 1.000 | 0.1000 |
| Practice expense | 0.36 | × 0.958 | 0.3449 |
| Malpractice | 0.01 | × 0.308 | 0.0031 |
| Total RVUs | 0.4480 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$14.96
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.1 | 1 |
| Practice expense | 0.36 | 0.958 |
| Malpractice | 0.01 | 0.308 |
(0.1 × 1 + 0.36 × 0.958 + 0.01 × 0.308) × $33.4009 = $14.96
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.
96375 billing questions
Which primary codes can 96375 be reported with?
Examples include an initial therapeutic IV infusion (96365), therapeutic IV push (96374), chemotherapy IV push (96409), or chemotherapy infusion (96413). Code 96375 cannot be billed alone.
How many units of 96375 can be billed in one encounter?
Report one unit for each different drug or substance administered by an additional sequential IV push. Repeating a push of the same drug does not create another unit of 96375.
What if the same drug is pushed again later in the visit?
A repeat push of the same drug does not qualify for 96375. In a facility, 96376 describes an additional push of that drug when it occurs more than 30 minutes after the prior push.
If the first administration is an IV push, is it reported with 96374 or 96375?
Select the initial service under the drug-administration hierarchy, not simply by administration order. If the encounter involves only therapeutic IV pushes, report 96374 for the initial drug and 96375 for each additional different drug.
Is an E/M visit separately billable on the same day?
A significant, separately identifiable E/M service beyond the usual pre-administration assessment may be reported with modifier 25 on the E/M code.
Does 96375 apply to chemotherapy drugs pushed after the initial chemotherapy service?
No. An additional sequential IV push of a chemotherapy or highly complex biologic drug is reported with 96411. Code 96375 describes an additional push of a nonchemotherapy therapeutic, prophylactic, or diagnostic drug.
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.
12,78696372,,Ther/proph/diag inj sc/im,A,,0.17,0.28,,0.28,NA,0.01,0.46,0.46,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78796373,,Ther/proph/diag inj ia,A,,0.17,0.41,,0.41,NA,0.01,0.59,0.59,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78896374,,Ther/proph/diag inj iv push,A,,0.18,0.93,,0.93,NA,0.02,1.13,1.13,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,78996375,,Tx/pro/dx inj new drug addon,A,,0.10,0.36,,0.36,NA,0.01,0.47,0.47,5,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79096376,,Tx/pro/dx inj same drug adon,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79196377,,Applicaton on-body injector,A,,0.17,0.39,,0.39,NA,0.01,0.57,0.57,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,79296379,,Unl ther/prop/diag inj/inf,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,