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See a sample rate comparisonCPT 96366 Fee Schedule
Last Verified: October 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 | Medicine Services and Procedures 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 | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $21.38 national non-facility rate (2026) · View Medicare rates for 96366 |
| Medicaid Fee Schedule | $16.87 median of the 8 states in the free preview · View Medicaid rates for 96366 |
National average reimbursement for CPT 96366 by major payers:
$29.52
$27.84
$28.63
$41.35
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CPT 96366
5 of 25 sample ratesHigher to lower in this preview
Nadia Ali
Advocare, LLC
$40.54Published rateArt Heinrich
$23.72Published rateSudha Garla
Atlantic Medical Associates
$20.20Published rateHoward Katz
$16.82Published rateHarry Lin
Bridge Point Medical Associates LLC
$15.43Published rate
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See a sample payer proposalCPT 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 Medicine Services and Procedures 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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Frequently Asked Questions
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.
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.
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.
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.
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.