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Injections, infusions & immunizations

96365 - RVUs & Medicare payment (2026)

IV infusion for therapy, initial hour.

Component Non-facility Facility
Work RVU 0.21 0.21
Practice expense RVU 1.76 1.76
Malpractice RVU 0.04 0.04
Total RVUs 2.01 2.01
National payment (CF $33.4009) $67.14 $67.14
Qualifying APM payment (CF $33.5675) $67.47 $67.47

How 96365 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 96365 ranges from $58.20 in Arkansas (AR) to $93.27 in San Jose-Sunnyvale-Santa Clara (CA); calculate 96365 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $93.27 San Jose-Sunnyvale-Santa Clara (CA) $93.08 San Francisco-Oakland-Berkeley (CA) $91.18 San Francisco-Oakland-Berkeley (CA) $91.14 Napa (CA) $85.61 Vallejo (CA) $85.55 Seattle (WA) $80.59 Santa Rosa-Petaluma (CA) $80.13 National average $67.14 … 97 more localities between … Alabama (AL) $59.21 Rest Of Missouri (MO) $58.99 Mississippi (MS) $58.62 Arkansas (AR) $58.20
Non-facility payment for 96365 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - injections, infusions & immunizations

  • 96372 · therapeutic injection, subcutaneous or intramuscular
  • 96374 · iv push, single or initial drug
  • 96401 · chemotherapy injection, subcutaneous or intramuscular
  • 96413 · chemotherapy iv infusion, first hour
  • 90471 · immunization administration, first vaccine
  • 90472 · immunization administration, each additional vaccine
  • 90460 · immunization administration with counseling, under 19, first component

Frequently asked questions

How much does Medicare pay for 96365 in 2026?
The national non-facility payment is $67.14 and the facility payment is $67.14, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.
What is the work RVU for 96365?
The 2026 work RVU for 96365 is 0.21. Total RVUs are 2.01 in the non-facility setting and 2.01 in the facility setting.
Why are the facility and non-facility amounts different?
Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.