FairBillCheck

CPT 96360: what Medicare pays in 2026

Infusion, injection or chemotherapy

Medicare's 2026 national amount for 96360 is $33.40 when a doctor's office or clinic bills it. Across Medicare's 109 payment localities the office amount runs from $29.38 in Arkansas to $45.98 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

CPT descriptions are copyrighted by the American Medical Association, so this page shows the code number only. The description printed on your bill, or the provider, will tell you what the code covers.

Medicare amounts for 96360 in 2026

Doctor's office or clinic, national
$33.40
Hospital outpatient rate, national (APC 5693)
$217.31
Hospital outpatient status S
separately paid procedure

Hospital outpatient rates are national figures before Medicare's wage adjustment, which moves about 60% of the rate up or down with local hospital wages.

What providers charged Medicare for 96360 in 2024

From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.

SettingServicesAverage chargeMedicare allowedCharge vs allowed
In an office or other non-facility setting222,445$166.48$31.695.3×

How Medicare builds the 96360 amount

Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.

Work RVU
0.17
Practice expense RVU, office
0.82
Malpractice RVU
0.01

96360 in every Medicare locality

The office amount is lowest in Arkansas and highest in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.

StateLocalityOfficeFacility
AKAlaska$37.87none
ALAlabama$29.83none
ARArkansas$29.38none
AZArizona$32.50none
CABakersfield$36.01none
CAChico$35.97none
CAEl Centro$35.97none
CAFresno$35.97none
CAHanford-Corcoran$35.97none
CALos Angeles-Long Beach-Anaheim (Los Angeles/Orange County)$38.53none
CAMadera$35.97none
CAMerced$35.97none
CAModesto$35.97none
CANapa$42.30none
CAOxnard-Thousand Oaks-Ventura$38.42none
CARedding$35.97none
CARest of California$35.97none
CARiverside-San Bernardino-Ontario$36.08none
CASacramento-Roseville-Folsom$37.91none
CASalinas$37.78none
CASan Diego-Chula Vista-Carlsbad$38.79none
CASan Francisco-Oakland-Berkeley (Marin County)$44.99none
CASan Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)$44.98none
CASan Jose-Sunnyvale-Santa Clara (San Benito County)$45.98none
CASan Jose-Sunnyvale-Santa Clara (Santa Clara County)$45.93none
CASan Luis Obispo-Paso Robles$37.15none
CASanta Cruz-Watsonville$39.25none
CASanta Maria-Santa Barbara$37.95none
CASanta Rosa-Petaluma$39.66none
CAStockton$35.97none
CAVallejo$42.29none
CAVisalia$35.97none
CAYuba City$35.97none
COColorado$35.15none
CTConnecticut$35.69none
DCDC + MD/VA Suburbs$38.62none
DEDelaware$33.07none
FLFort Lauderdale$34.03none
FLMiami$35.03none
FLRest of Florida$32.36none
GAAtlanta$33.92none
GARest of Georgia$30.51none
HIHawaii, Guam$37.01none
IAIowa$30.87none
IDIdaho$31.03none
ILChicago$34.01none
ILEast St. Louis$31.55none
ILRest of Illinois$31.21none
ILSuburban Chicago$34.44none
INIndiana$31.23none
KSKansas$30.61none
KYKentucky$30.33none
LANew Orleans$31.83none
LARest of Louisiana$30.24none
MAMetropolitan Boston$38.91none
MARest of Massachusetts$34.88none
MDBaltimore/Surrounding Counties$35.57none
MDRest of Maryland$33.76none
MERest of Maine$31.08none
MESouthern Maine$33.03none
MIDetroit$32.67none
MIRest of Michigan$31.06none
MNMinnesota$33.96none
MOMetropolitan Kansas City$31.72none
MOMetropolitan St. Louis$32.09none
MORest of Missouri$29.61none
MSMississippi$29.51none
MTMontana$33.40none
NCNorth Carolina$31.45none
NDNorth Dakota$33.20none
NENebraska$31.08none
NHNew Hampshire$34.48none
NJNorthern NJ$38.16none
NJRest of New Jersey$36.18none
NMNew Mexico$31.19none
NVNevada$33.37none
NYManhattan$38.40none
NYNYC Suburbs/Long Island$39.23none
NYPoughkeepsie/Northern NYC Suburbs$36.33none
NYQueens$38.90none
NYRest of New York$31.93none
OHOhio$31.02none
OKOklahoma$30.40none
ORPortland$36.45none
ORRest of Oregon$33.19none
PAMetropolitan Philadelphia$34.69none
PARest of Pennsylvania$31.14none
PRPuerto Rico$33.70none
RIRhode Island$34.38none
SCSouth Carolina$31.27none
SDSouth Dakota$33.18none
TNTennessee$30.75none
TXAustin$34.96none
TXBeaumont$30.91none
TXBrazoria$33.13none
TXDallas$33.30none
TXFort Worth$33.03none
TXGalveston$33.20none
TXHouston$33.38none
TXRest of Texas$31.97none
UTUtah$31.72none
VAVirginia$32.84none
VIVirgin Islands$33.70none
VTVermont$32.96none
WARest of Washington$34.85none
WASeattle (King County)$39.84none
WIWisconsin$32.02none
WVWest Virginia$29.96none
WYWyoming$33.31none

Other infusion, injection or chemotherapy codes