What is CPT code 96366?

CPT code 96366 is used for Intravenous Infusion, For Therapy, Prophylaxis, Or Diagnosis (Specify Substance Or Drug); Each Additional Hour. It describes a moderate-complexity encounter, often including multiple diagnoses or prescription management.

What factors affect CPT 96366 fee schedules?

Factors affecting fee schedules for CPT 96366 include Medicare & Medicaid rates (government-set), private insurance rates (negotiated between providers and insurers), geographic location (costs may be higher in urban areas), and provider type (hospital vs. private practice).

How can PayerPrice help with CPT 96366 fee schedules?

PayerPrice allows users to view exact negotiated rates that insurers publish under federal transparency rules. This data helps benchmark current rates, prospect for new business, and integrate real-time payer data into workflows.

How can I find out the cost of a specific medical procedure or service?

To determine the cost of a specific medical procedure or service, you generally need to know the CPT (Current Procedural Terminology) code for that service and your geographic location. Prices can vary significantly based on these factors, as well as the specific provider, your insurance plan, and other variables. For an accurate estimate tailored to your specific situation, it is recommended to use a specialized tool. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to find relevant pricing information.

What factors influence the price of a medical service?

Many factors influence the price of a medical service. Key elements include the specific CPT code (which identifies the procedure or service), the geographic location where the service is provided, the type of facility (e.g., hospital, outpatient clinic, doctor's office), the healthcare provider's specific charges, and your insurance coverage. Due to this complexity, prices can vary significantly even for the same service. To understand pricing relevant to your specific situation, using a tool like Payerprice's fee schedule lookup can provide valuable insight based on CPT codes and locations.

Are medical procedure prices transparent or easily accessible?

Historically, medical procedure prices have not always been transparent or easily accessible to consumers. However, efforts are being made to improve price transparency. While you can often get an estimate directly from your provider, for a comprehensive search across different providers or to understand typical rates in a specific area, specialized tools are beneficial. For detailed fee schedule information based on CPT codes and specific locations, Payerprice offers a lookup tool designed to help users access this data more readily.

What is a CPT code and why is it important for understanding costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers, payers, and facilities to standardize the reporting of medical, surgical, and diagnostic services. These codes are crucial for understanding costs because they are the foundation upon which fee schedules and insurance claims are built. When you have the CPT code for a specific service, you can use it to research average costs, compare prices, and get more precise estimates for that particular procedure in your location. Payerprice's tool utilizes CPT codes for its fee schedule lookup.

Where can I find typical charges or fee schedules for specific medical services in my area?

Finding typical charges or fee schedules for specific medical services in your area can be complex, as prices vary. While some insurance companies provide tools for their members, for a broader search using CPT codes and specific locations, it's best to use dedicated platforms. Payerprice offers a fee schedule lookup tool that allows users to search with a CPT code and a specific geographic location to find relevant pricing information, helping you understand the typical costs in your area.

CPT 96366 Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Ther Proph Diag Iv Inf Addon, Intravenous Infusion For Therapy Prophylaxis Or Diagnosis Specify Substance Or Drug Each Additional Hour List Separately In Addition To Code For Primary Procedure

Key Fact	Detail
Service Type	Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration) Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration
Common Place of Service	11 - Office 99 - Other POS
Common Modifiers	None 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 96366

National average reimbursement for CPT 96366 by major payers:

$29.52

$27.84

$28.63

$41.35

Preview provider-level rates for...

For billing codeCPT 96366

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	96366	$15.43	1881648541 - MEHNAZ HAQ	845179326 - (NJ) TALKMD CLINICIANS PA	NJ	Internal Medicine Physician (207R00000X)
United	96366	$21.38	1528262961 - GAMMAL HASSANIEN	261411967 - (NJ) G&S MEDICAL	NJ	Internal Medicine Physician (207R00000X)
United	96366	$40.54	1487728861 - NADIA ALI	223537011 - ADVOCARE, LLC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$16.82	1467452565 - ELSAYED SAHLOUL	471062829 - (NJ) HAZLET MEDICAL SERVICES LLC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$23.72	1386665701 - ART HEINRICH	222864724	NJ	Internal Medicine Physician (207R00000X)
United	96366	$16.77	1255404927 - SASAN PARANGI	1255404927 - (NJ) SASAN PARANGI	NJ	Internal Medicine Physician (207R00000X)
United	96366	$20.20	1659330629 - SUDHA GARLA	223065690 - (NJ) ATLANTIC MEDICAL ASSOCIATES	NJ	Internal Medicine Physician (207R00000X)
United	96366	$15.43	1538105895 - HARRY LIN	262666468 - (NJ) BRIDGE POINT MEDICAL ASSOCIATES LLC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$16.82	1659330629 - SUDHA GARLA	223065690 - (NJ) ATLANTIC MEDICAL ASSOCIATES	NJ	Internal Medicine Physician (207R00000X)
United	96366	$20.13	1346695442 - VISHNU RAVI	223665605 - (NJ) USHAPANICKER MDLLC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$16.77	1144589730 - MUHAMMAD UPPAL	851052035 - (NJ) HUDSON HEALTHCARE EXPRESS	NJ	Internal Medicine Physician (207R00000X)
United	96366	$40.54	1386329605 - ADVOCARE , LLC, ADVOCARE VOORHEES MEDICINE	223537011 - ADVOCARE, LLC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$23.72	1417976531 - TERESA THOMAS	223479965 - (NJ) EASTERN MEDICAL ASSOCIATES PC	NJ	Internal Medicine Physician (207R00000X)
United	96366	$16.77	1881648541 - MEHNAZ HAQ	845179326 - (NJ) TALKMD CLINICIANS PA	NJ	Internal Medicine Physician (207R00000X)
United	96366	$37.66	1013246099 - LORENZA FRISONI	223537011 - ADVOCARE, LLC	NJ	Internal Medicine Physician (207R00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 96366 vs. Other Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Codes

The CPT 96366 code is part of the Therapeutic, Prophylactic, and Diagnostic Injections and Infusions (Excludes Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration) services used for Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 96366 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
96360-CPT	Low	Fluids Given By Iv To Hydrate, Saline Or Other Fluids Given By Iv. The Fluids Rehydrate The Body After The Normal Fluid Level Has Dropped From Vomiting Diarrhea A High Fever Or Other Symptom.
96361-CPT	Low	Fluids Given By Iv To Hydrate, Saline Or Other Fluids Given By Iv. The Fluids Rehydrate The Body After The Normal Fluid Level Has Dropped From Vomiting Diarrhea A High Fever Or Other Symptom.
96365-CPT	Low	Iv Infusion, An Iv Infusion Delivers A Fluid Or Medication Over One Hour. Infusion May Be Part Of A Therapy Preventive Measure Or A Part Of A Test.
96366-CPT	Low	Ther Proph Diag Iv Inf Addon, Intravenous Infusion For Therapy Prophylaxis Or Diagnosis Specify Substance Or Drug Each Additional Hour List Separately In Addition To Code For Primary Procedure

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96366. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 96366 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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