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See a sample rate comparisonCPT 96373 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.
Injection, An Injection Into The Skin A Muscle Or An Artery. A Drug Or Other Substance May Be Given As A Therapy A Preventive Measure Or To Aid Diagnosis.
| 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 20 - Urgent Care Facility |
| Common Modifiers | 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $19.71 national non-facility rate (2026) · View Medicare rates for 96373 |
| Medicaid Fee Schedule | $15.555 median of the 8 states in the free preview · View Medicaid rates for 96373 |
National average reimbursement for CPT 96373 by major payers:
$26.91
$23.88
$23.43
$38.72
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CPT 96373
5 of 25 sample ratesHigher to lower in this preview
Andrew Knox
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
$51.47Published ratePaul Dobransky
Advocate Health And Hospitals Corporation
$38.22Published rateJamie Evans
Loyola University Medical Center
$35.43Published rateEugene Schnitzler
Loyola University Medical Center
$29.38Published rateSherrie Levy
Carle Health Care Incorporated
$18.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 96373 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 96373 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 96373 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 |
|---|---|---|
| 96372-CPT | Low | Therpeutic, Prophylactic Or Diagnostic Injection {Specify Substance Or Drug}; Subcutaneous Or Intramuscular Nurse Pracitioner Rendering Service In Collaborati |
| 96373-CPT | Low | Injection, An Injection Into The Skin A Muscle Or An Artery. A Drug Or Other Substance May Be Given As A Therapy A Preventive Measure Or To Aid Diagnosis. |
| 96374-CPT | Low | Injection Into Vein Or Iv, A Drug Is Given By Injection Into A Vein Or Through An Iv Over A Short Amount Of Time. Additional Injections May Be Given Of The Same Or A Different Drug. |
| 96375-CPT | Low | Tx Pro Dx Inj New Drug Addon, Therapeutic Prophylactic Or Diagnostic Injection Specify Substance Or Drug Each Additional Sequential Intravenous Push Of A New Substance Drug 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 96373. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96373 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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