CPT 96372 Chemotherapy/Infusion

How Much Does Therapeutic Injection (Intramuscular or Subcutaneous) Cost?

Also known as: Ther/proph/diag inj sc/im (CPT 96372)

An injection of medication into a muscle or under the skin.

Therapeutic Injection (Intramuscular or Subcutaneous) (CPT 96372) costs $15 at Medicare rates. Hospital outpatient rate: $74.

Cost Comparison by Payer

How much Ther/proph/diag inj sc/im costs across different settings and payers

Medicare
Facility rate
$15
Hospital Outpatient
OPPS rate
$74
Medicare (Facility)
$15
CMS PFS 2026 national rate
Hospital Outpatient
$74
OPPS rate

Patient Guide: Therapeutic Injection (Intramuscular or Subcutaneous)

What you need to know before your appointment

What to Expect

A healthcare worker injects medication using a syringe. The injection site depends on the medication type.

How Long Does It Take?

5-10 minutes

Common Reasons Doctors Order This

Pain medication, steroid injection, vitamin B12, hormone injection, allergy treatment

How to Prepare

No special preparation usually needed. Tell staff about medication allergies.

Procedures Commonly Done Together

These procedures are frequently performed alongside Ther/proph/diag inj sc/im

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How to Reduce Your Cost for Ther/proph/diag inj sc/im

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
0.28
Practice Expense RVU
0.01
Malpractice RVU
0.46
Total RVU

Payment = Total RVU (0.46) x CF ($33.40) = $15

Frequently Asked Questions

How much does Ther/proph/diag inj sc/im cost?

The Medicare facility rate for Ther/proph/diag inj sc/im is $15. In a hospital outpatient setting, the rate is $74. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Ther/proph/diag inj sc/im cost without insurance?

Without insurance, the cost of Ther/proph/diag inj sc/im 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 Ther/proph/diag inj sc/im?

Most commercial health insurance plans and Medicare cover Ther/proph/diag inj sc/im 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.

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