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See a sample rate comparisonCPT 96374 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 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.
| 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 XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $37.74 national non-facility rate (2026) · View Medicare rates for 96374 |
| Medicaid Fee Schedule | $31.04 median of the 8 states in the free preview · View Medicaid rates for 96374 |
National average reimbursement for CPT 96374 by major payers:
$59.22
$59.67
$61.36
$76.93
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CPT 96374
5 of 25 sample ratesHigher to lower in this preview
Felicitas Gonzales
Bhs Physicians Network, Inc
$98.57Published rateCharlotte Cardiovacular Institute, PA
Charlotte Cardiovascular Institute, P.A.
$61.02Published rateMaria Cerana
Villagemd Of Southeast Texas, PA
$46.07Published rateRoyal V.P., LLC
Royal Vp LLC
$35.37Published rateMartindale Family Medicine Clinic PA
$29.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 96374 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 96374 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 96374 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 |
|---|---|---|
| 96370-CPT | Low | Infusion Under The Skin, An Infusion Under The Skin Uses A Pump To Deliver A Fluid Or Medication Over A Period Of Several Hours. Infusion May Be Part Of A Therapy Preventive Measure Or A Part Of A Test. |
| 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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96374. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96374 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
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit alphanumeric codes used by healthcare providers to report medical, surgical, and diagnostic services to entities like insurers and government agencies for billing and reimbursement purposes.
The cost of a medical procedure can vary significantly based on your location, the specific provider, your insurance plan, and other factors. To get an estimate for a specific CPT code and your location, you can use a tool like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to get transparent pricing information.
A fee schedule is a complete listing of fees used by health insurance plans and government programs (like Medicare) to pay doctors and other providers. It specifies the maximum dollar amount that the plan or program will pay for a specific medical service or procedure, typically identified by a CPT code.
Payerprice is a platform that provides transparency into healthcare costs. It offers a fee schedule lookup tool where users can search for the prices of medical services using CPT codes and specific locations. This allows individuals to compare costs and make more informed decisions about their healthcare.
Payerprice helps you understand healthcare costs by providing access to fee schedules for various medical procedures. By inputting a CPT code and your location, you can see estimated prices, helping you anticipate potential out-of-pocket expenses, compare providers, and negotiate prices if you are self-pay. It empowers you with information that was traditionally difficult for consumers to access.
While Payerprice provides comprehensive fee schedule data based on CPT codes and locations, the exact price you will pay can still depend on your individual insurance plan's deductible, co-pays, co-insurance, and network status. Payerprice offers valuable estimates and transparency, but it's always advisable to verify with your insurance provider and the healthcare facility for your specific out-of-pocket costs.
While CMS (Centers for Medicare & Medicaid Services) provides extensive data, including Medicare's fee schedules, it primarily focuses on Medicare-specific pricing. Payerprice offers a broader fee schedule lookup tool that allows users to search with CPT codes and specific locations, which can include a wider range of payer data beyond just Medicare. For a comprehensive understanding of prices that are relevant to your specific situation and location, including commercial rates, Payerprice is a more tailored and user-friendly solution.