CPT 96422 Chemotherapy/Infusion

How Much Does Chemotherapy Ia Infusion up to 1 Hour Cost?

Also known as: Chemo ia infusion up to 1 hr (CPT 96422)

Chemotherapy Ia Infusion up to 1 Hour (CPT 96422) costs $140 at Medicare rates. Hospital outpatient rate: $337.

Cost Comparison by Payer

How much Chemo ia infusion up to 1 hr costs across different settings and payers

Medicare
Facility rate
$140
Hospital Outpatient
OPPS rate
$337
Medicare (Facility)
$140
CMS PFS 2026 national rate
Hospital Outpatient
$337
OPPS rate

Procedures Commonly Done Together

These procedures are frequently performed alongside Chemo ia infusion up to 1 hr

Loading related procedures...

How to Reduce Your Cost for Chemo ia infusion up to 1 hr

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.17
Work RVU
3.96
Practice Expense RVU
0.07
Malpractice RVU
4.20
Total RVU

Payment = Total RVU (4.20) x CF ($33.40) = $140

Frequently Asked Questions

How much does Chemo ia infusion up to 1 hr cost?

The Medicare facility rate for Chemo ia infusion up to 1 hr is $140. In a hospital outpatient setting, the rate is $337. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Chemo ia infusion up to 1 hr cost without insurance?

Without insurance, the cost of Chemo ia infusion up to 1 hr can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Chemo ia infusion up to 1 hr?

Most commercial health insurance plans and Medicare cover Chemo ia infusion up to 1 hr when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

Share This Cost Information

My Cost List

0 procedures

No procedures added yet

Click "Add to My List" on any procedure to start building your estimate.