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See a sample rate comparisonCPT 96450 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.
Chemotherapy Administration I, Chemotherapy Administration Into Cns (Eg Intrathecal)Requiring And Including Lumbar Puncture Chemotherapy Administration Into Cns (Eg Intrathecal)
| 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 | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $160.99 national non-facility rate (2026) · View Medicare rates for 96450 |
| Medicaid Fee Schedule | $129.74 median of the 8 states in the free preview · View Medicaid rates for 96450 |
National average reimbursement for CPT 96450 by major payers:
$221.68
$253.37
$267.21
$138.39
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CPT 96450
5 of 25 sample ratesHigher to lower in this preview
Alexandra Pedicone
Stony Brook Internists P C
$594.79Published rateLouis Gleckel
Caremount Medical, P.C.
$395.72Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$312.35Published rateJames Chambliss
The Board Of Trustees Of The University Of Illinois
$231.05Published rateAbbas Naqvi
Town Center Orthopaedic Associates, P.C.
$97.10Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 96450 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 96450 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 96450 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 |
|---|---|---|
| 96450-CPT | Moderate | Chemotherapy Administration I, Chemotherapy Administration Into Cns (Eg Intrathecal)Requiring And Including Lumbar Puncture Chemotherapy Administration Into Cns (Eg Intrathecal) |
| 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) |
| 96542-CPT | Low | Chemotherapy Injection Subara, Chemotherapy Injection Subarachnoid Or Intraventricular Viasubcutaneous Reservoir Single Or Multiple Agents |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96450. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96450 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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