CPT Administration Code: 96405 | Chemotherapy Administration

Code Overview

CPT® administration code details for 96405.

CPT Code Descriptor Chemotherapy administration; intralesional, up to and including 7 lesions

Code Category Chemotherapy Administration

Route / Technique Intralesional Injection

Code Type Initial / Primary Code

About Chemotherapy Administration – 96405

CPT 96405 reports intralesional chemotherapy administration involving injection into up to seven lesions during a single encounter. It is used specifically for anti-neoplastic agents injected directly into lesions, such as certain skin or subcutaneous tumors, rather than systemic subcutaneous or intramuscular injection. This code is reported once per encounter regardless of how many lesions, up to seven, are treated.

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96405 RVU Breakdown & Medicare Reimbursement

Based on the CY 2026 CMS Physician Fee Schedule. National payment amounts, before geographic (GPCI) adjustment.

Component	Facility	Non-Facility
Work RVU — physician work	0.52	0.52
Practice Expense RVU — staff, supplies, equipment	0.16	1.98
Malpractice RVU — professional liability	0.03	0.03
Total RVUs	0.71	2.53
Medicare Payment — Total RVUs × $33.4009 CF	$23.71	$84.50

CY 2026 Medicare Conversion Factor: $33.4009.

96405 Locality-Adjusted Rates

Medicare payment varies by locality via GPCI adjustment. Log in to view rates for all 100+ Medicare localities.

Medicare Locality	Facility	Non-Facility
National (unadjusted)	$23.71	$84.50
Los Angeles–Long Beach, CA
Manhattan, NY
Houston, TX
Miami, FL

Related Administration Codes

The chemotherapy injection code family. Report one initial code per encounter; add-on codes are listed separately in addition to the primary procedure.

CPT Code	Description	Type
96401	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic	Initial
96402	Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic	Initial
96405This page	Chemotherapy administration; intralesional, up to and including 7 lesions	Initial

Frequently Asked Questions

What are CPT Administration Codes?

CPT administration codes cover the work of giving a drug to a patient, such as an injection or an infusion. The drug itself is billed with its HCPCS J-code, and the administration is billed with a CPT code. Both go on the same claim. Learn More →

What is the Medicare Conversion Factor?

The conversion factor is the dollar amount CMS uses to turn a code's total RVUs into a Medicare payment. This page uses the CY 2026 conversion factor of $33.4009. CMS updates it every year in the Physician Fee Schedule final rule.

Facility vs. Non-Facility?

The non-facility rate applies in a physician office, where the practice pays for its own staff, supplies, and equipment, so the rate is usually higher. The facility rate applies in hospital outpatient departments and ASCs, where the facility bills for those costs separately.

How do I decide which administration code to use?

Pick the code that matches the type of drug, the route, and how long the administration takes. Start from the highest-ranking service you performed, then add the appropriate add-on codes for extra time or extra drugs. Manufacturer billing and coding guides often list suggested administration codes.

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CPT Administration Code: 96405 – Chemotherapy Administration