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See a sample rate comparisonHealthcare 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.
| 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 | 20 - Urgent Care Facility 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 96440 |
| Medicaid Fee Schedule | View Medicaid rates for 96440 |
National average reimbursement for CPT 96440 by major payers:

$846.95

$937.92

$954.25

$1,146.31
Choose a payer to see a sample of rates for CPT 96440.
Bend Memorial Clinic, PC
Advocate Health And Hospitals Corporation
The Board Of Trustees Of The University Of Illinois
Saint Anthony Health Affiliates
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Rate Benchmarking
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See a sample payer proposalCPT 96440 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 96440 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 96440 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 |
|---|---|---|
| 96440-CPT | Moderate | Drug Instilled Into Body Space, A Chemotherapy Agent Or Other Complex Drug Is Given By Instilling One Or More Drugs Into A Body Cavity Or Space. The Drug May Be Injected Though A Thin Tube (Catheter) That Has Been Implanted Previously. |
| 96521-CPT | Low | Infusion Pump Maintenance, Refill And Maintenance Of Either A Portable Or An Implanted Pump Used For Delivering Chemotherapy. |
| 96522-CPT | Low | Refilling And Maintenance Of I, Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery Systemic (Eg Intravenous Intra-Arterial) |
| 96523-CPT | Low | Clean Drug Access Port, A Procedure To Wash Out An Access Port Implanted Into A Vein. The Port Is Used To Inject Drugs For Therapies. Cleaning Keeps Clots From Plugging The Port. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96440. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96440 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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