CPT 96413 Oncology
Chemotherapy IV infusion, first hour Cost
Body System: General
Medicare Facility Rate
$44
CMS PFS CY2026
Medicare Non-Facility Rate
$158
Office/clinic setting
Hospital Outpatient
$337
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.49
Work RVU
0.85
Facility PE RVU
0.03
Malpractice RVU
Cost by Location
| Location | Medicare Rate | Est. Commercial |
|---|---|---|
| US — Carrier 01112 Locality 05 | $184 | $275 — $459 |
| US — Carrier 01112 Locality 09 | $188 | $281 — $469 |
| US — Carrier 01112 Locality 51 | $172 | $258 — $431 |
| US — Carrier 01112 Locality 52 | $184 | $275 — $459 |
| US — Carrier 01112 Locality 53 | $172 | $258 — $430 |
| US — Carrier 01112 Locality 54 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 55 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 56 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 57 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 58 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 59 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 60 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 61 | $145 | $217 — $362 |
| US — Carrier 01112 Locality 62 | $145 | $218 — $364 |
| US — Carrier 01112 Locality 63 | $153 | $230 — $383 |
| US — Carrier 01112 Locality 64 | $153 | $229 — $381 |
| US — Carrier 01112 Locality 65 | $188 | $282 — $470 |
| US — Carrier 01112 Locality 66 | $159 | $239 — $398 |
| US — Carrier 01112 Locality 67 | $161 | $241 — $402 |
| US — Carrier 01112 Locality 68 | $145 | $217 — $362 |
Frequently Asked Questions
How much does Chemotherapy IV infusion, first hour cost?
The Medicare facility rate is $44. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $337.
How much does Chemotherapy IV infusion, first hour 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 $44.