CPT Administration Code: 96365 | Intravenous Infusion

Code Overview

CPT® administration code details for 96365.

CPT Code Descriptor Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

Code Category Intravenous Infusion

Route / Technique Intravenous Infusion

Code Type Initial / Primary Code

About Intravenous Infusion – 96365

CPT 96365 reports the initial intravenous infusion of a therapeutic, prophylactic, or diagnostic substance or drug, covering the first hour of infusion. It is used when a medication other than chemotherapy is administered intravenously for treatment, prevention, or diagnostic purposes, and it is reported once per encounter as the primary initial infusion service. This code establishes the base service to which additional infusion time or additional drug infusions may be added.

Disclaimer: CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved. The information on BuyandBill.com is intended for informational purposes only and should not be used as billing or medical advice.

96365 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	0.21	0.21
Practice Expense RVU — staff, supplies, equipment	1.76	1.76
Malpractice RVU — professional liability	0.04	0.04
Total RVUs	2.01	2.01
Medicare Payment — Total RVUs × $33.4009 CF	$67.14	$67.14

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

96365 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)	$67.14	$67.14
Los Angeles–Long Beach, CA
Manhattan, NY
Houston, TX
Miami, FL

Related Administration Codes

The therapeutic 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
96365This page	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour	Initial
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)	Add-on
96367	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)	Add-on
96368	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)	Add-on

Drugs Commonly Billed with 96365

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

HCPCS Code	Drug	HCPCS Descriptor
J3262	ACTEMRA	Injection, tocilizumab, 1 mg
J0885	EPOGEN	Injection, epoetin alfa, (for non-esrd use), 1000 units
J1299	SOLIRIS	Injection, eculizumab, 2 mg
J3358	STELARA	Ustekinumab, for intravenous injection, 1 mg
J0130	ABCIXIMAB	Injection abciximab, 10 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.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.

CPT Administration Code: 96365 – Intravenous Infusion