CPT Administration Code: 96413 | Chemotherapy Administration

Code Overview

CPT® administration code details for 96413.

CPT Code Descriptor Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

Code Category Chemotherapy Administration

Route / Technique Intravenous Infusion

Code Type Initial / Primary Code

About Chemotherapy Administration – 96413

CPT 96413 covers the initial intravenous infusion of a chemotherapy or other highly complex drug or biologic agent, for infusions lasting up to one hour. It is reported once per encounter as the primary infusion service and serves as the base code from which additional hourly increments or concurrent/sequential services are built using related add-on codes.

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96413 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	0.28	0.28
Practice Expense RVU — staff, supplies, equipment	3.64	3.64
Malpractice RVU — professional liability	0.07	0.07
Total RVUs	3.99	3.99
Medicare Payment — Total RVUs × $33.4009 CF	$133.27	$133.27

CY 2026 Medicare Conversion Factor: $33.4009. Facility and non-facility practice-expense RVUs are equal for this code.

96413 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)	$133.27	$133.27
Los Angeles–Long Beach, CA
Manhattan, NY
Houston, TX
Miami, FL

Related Administration Codes

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

CPT Code	Description	Type
96413This page	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	Initial
96415	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)	Add-on
96416	Chemotherapy administration, IV infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours) requiring use of a portable or implantable pump	Initial
96417	Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug) up to 1 hour (List separately in addition to code for primary procedure)	Add-on

Drugs Commonly Billed with 96413

HCPCS-coded drugs frequently administered under this CPT code. The list below is not exhaustive.

HCPCS Code	Drug	HCPCS Descriptor
J9035	AVASTIN	Injection, bevacizumab, 10 mg
J9355	HERCEPTIN	Injection, trastuzumab, excludes biosimilar, 10 mg
J1745	Remicade	Injection, infliximab, excludes biosimilar, 10 mg
J9312	RITUXAN	Injection, rituximab, 10 mg
J2323	TYSABRI	Injection, natalizumab, 1 mg

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: 96413 – Chemotherapy Administration