CPT 96165 Other
Hlth bhv ivntj grp ea addl Cost
Body System: General
Medicare Facility Rate
$4
CMS PFS CY2026
Medicare Non-Facility Rate
$5
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.11
Work RVU
0.01
Facility PE RVU
0.15
Total RVU
Frequently Asked Questions
How much does Hlth bhv ivntj grp ea addl cost?
The Medicare facility rate is $4. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Hlth bhv ivntj grp ea addl cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $4.