FairBillCheck

CPT 96374: what Medicare pays in 2026

Infusion, injection or chemotherapy

Medicare's 2026 national amount for 96374 is $37.74 when a doctor's office or clinic bills it. Across Medicare's 109 payment localities the office amount runs from $33.04 in Arkansas to $51.82 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 96374 in 2026

Doctor's office or clinic, national
$37.74
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 96374 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 setting208,171$154.04$36.524.2×

How Medicare builds the 96374 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
0.18
Practice expense RVU, office
0.93
Malpractice RVU
0.02

96374 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$42.47none
ALAlabama$33.57none
ARArkansas$33.04none
AZArizona$36.68none
CABakersfield$40.58none
CAChico$40.52none
CAEl Centro$40.52none
CAFresno$40.52none
CAHanford-Corcoran$40.52none
CALos Angeles-Long Beach-Anaheim (Los Angeles/Orange County)$43.45none
CAMadera$40.52none
CAMerced$40.52none
CAModesto$40.52none
CANapa$47.67none
CAOxnard-Thousand Oaks-Ventura$43.31none
CARedding$40.52none
CARest of California$40.52none
CARiverside-San Bernardino-Ontario$40.74none
CASacramento-Roseville-Folsom$42.71none
CASalinas$42.56none
CASan Diego-Chula Vista-Carlsbad$43.71none
CASan Francisco-Oakland-Berkeley (Marin County)$50.69none
CASan Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)$50.67none
CASan Jose-Sunnyvale-Santa Clara (San Benito County)$51.82none
CASan Jose-Sunnyvale-Santa Clara (Santa Clara County)$51.73none
CASan Luis Obispo-Paso Robles$41.85none
CASanta Cruz-Watsonville$44.24none
CASanta Maria-Santa Barbara$42.76none
CASanta Rosa-Petaluma$44.70none
CAStockton$40.52none
CAVallejo$47.64none
CAVisalia$40.52none
CAYuba City$40.52none
COColorado$39.66none
CTConnecticut$40.40none
DCDC + MD/VA Suburbs$43.67none
DEDelaware$37.33none
FLFort Lauderdale$38.69none
FLMiami$40.04none
FLRest of Florida$36.71none
GAAtlanta$38.39none
GARest of Georgia$34.52none
HIHawaii, Guam$41.72none
IAIowa$34.70none
IDIdaho$34.91none
ILChicago$38.81none
ILEast St. Louis$35.94none
ILRest of Illinois$35.42none
ILSuburban Chicago$39.14none
INIndiana$35.13none
KSKansas$34.43none
KYKentucky$34.24none
LANew Orleans$36.00none
LARest of Louisiana$34.14none
MAMetropolitan Boston$43.94none
MARest of Massachusetts$39.35none
MDBaltimore/Surrounding Counties$40.27none
MDRest of Maryland$38.12none
MERest of Maine$35.01none
MESouthern Maine$37.22none
MIDetroit$37.11none
MIRest of Michigan$35.13none
MNMinnesota$38.17none
MOMetropolitan Kansas City$35.83none
MOMetropolitan St. Louis$36.25none
MORest of Missouri$33.44none
MSMississippi$33.25none
MTMontana$37.74none
NCNorth Carolina$35.42none
NDNorth Dakota$37.35none
NENebraska$34.94none
NHNew Hampshire$38.93none
NJNorthern NJ$43.14none
NJRest of New Jersey$40.91none
NMNew Mexico$35.30none
NVNevada$37.66none
NYManhattan$43.55none
NYNYC Suburbs/Long Island$44.57none
NYPoughkeepsie/Northern NYC Suburbs$41.10none
NYQueens$44.08none
NYRest of New York$35.99none
OHOhio$35.05none
OKOklahoma$34.27none
ORPortland$41.12none
ORRest of Oregon$37.42none
PAMetropolitan Philadelphia$39.25none
PARest of Pennsylvania$35.16none
PRPuerto Rico$38.07none
RIRhode Island$38.81none
SCSouth Carolina$35.28none
SDSouth Dakota$37.30none
TNTennessee$34.61none
TXAustin$39.48none
TXBeaumont$34.90none
TXBrazoria$37.36none
TXDallas$37.58none
TXFort Worth$37.28none
TXGalveston$37.46none
TXHouston$37.82none
TXRest of Texas$36.09none
UTUtah$35.81none
VAVirginia$37.02none
VIVirgin Islands$38.07none
VTVermont$37.10none
WARest of Washington$39.31none
WASeattle (King County)$44.97none
WIWisconsin$35.98none
WVWest Virginia$33.96none
WYWyoming$37.57none

Other infusion, injection or chemotherapy codes