CPT 96367 Chemotherapy/Infusion

How Much Does Treatment/proph/dg Additional Seq Intravenous Inf Cost?

Also known as: Tx/proph/dg addl seq iv inf (CPT 96367)

Treatment/proph/dg Additional Seq Intravenous Inf (CPT 96367) costs $30 at Medicare rates. Hospital outpatient rate: $74.

Cost Comparison by Payer

How much Tx/proph/dg addl seq iv inf costs across different settings and payers

Medicare
Facility rate
$30
Hospital Outpatient
OPPS rate
$74
Medicare (Facility)
$30
CMS PFS 2026 national rate
Hospital Outpatient
$74
OPPS rate

Procedures Commonly Done Together

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How to Reduce Your Cost for Tx/proph/dg addl seq iv inf

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.

0.19
Work RVU
0.69
Practice Expense RVU
0.01
Malpractice RVU
0.89
Total RVU

Payment = Total RVU (0.89) x CF ($33.40) = $30

Frequently Asked Questions

How much does Tx/proph/dg addl seq iv inf cost?

The Medicare facility rate for Tx/proph/dg addl seq iv inf is $30. 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 Tx/proph/dg addl seq iv inf cost without insurance?

Without insurance, the cost of Tx/proph/dg addl seq iv inf 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 Tx/proph/dg addl seq iv inf?

Most commercial health insurance plans and Medicare cover Tx/proph/dg addl seq iv inf 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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