How much does Medicare pay for CPT 96366?

Medicare allowed an average of $19.49 per service and paid $15.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $89.33, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96366?

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour. It was billed 494,967 times to 77,017 Medicare beneficiaries by 3,065 providers in 2024.

Which specialty bills 96366 most?

Hematology-Oncology, with 168,775 services from 1,439 clinicians. Next are Nurse Practitioner, Neurology, Medical Oncology.

CPT 96366

Infusion into a vein for therapy, prevention, or diagnosis, each additional hour

$19.49Medicare-allowed amount per service, averaged across 494,967 services

Providers submitted

$89.33

Asking price, not received

Medicare allowed

$19.49

The fee schedule figure

Medicare paid

$15.31

Balance is patient coinsurance

Providers submitted an average of $89.33 for this code and Medicare allowed $19.49 — 4.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $15.31 (79%); the rest is the patient’s coinsurance and deductible.

Services: 494,967
Beneficiaries: 77,017
Providers billing it: 3,065
Total allowed: $9,646,907

What Medicare pays for CPT 96366

Across 494,967 services billed by 3,065 providers to 77,017 beneficiaries, Medicare allowed an average of $19.49 per service. That is 6.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 96366

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	168,775	36,774	$20.04	1,439
Nurse Practitioner	73,033	7,952	$16.52	355
Neurology	62,770	3,445	$20.40	142
Medical Oncology	42,563	9,984	$19.77	415
Internal Medicine	26,906	4,349	$20.31	155
Family Practice	21,646	2,092	$19.67	69
Infectious Disease	19,941	1,997	$19.63	85
Rheumatology	19,189	2,920	$20.80	123
Allergy/ Immunology	13,184	1,186	$20.25	44
Physician Assistant	6,141	1,049	$16.77	47
Hematology	4,744	1,318	$21.07	57
Anesthesiology	3,930	341	$19.48	10
Pain Management	3,631	370	$19.68	8
Pediatric Medicine	2,926	156	$18.99	4
Nephrology	2,888	406	$22.51	5

96366 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	68,495	$18.82	$15.23	394
Florida	62,544	$19.33	$15.40	368
California	59,718	$22.16	$15.50	247
New York	34,629	$22.13	$15.48	189
Illinois	19,549	$19.21	$15.40	155
Georgia	19,153	$17.35	$14.72	82
Arizona	18,074	$18.96	$15.24	103
New Jersey	15,591	$21.65	$15.47	82
Tennessee	15,094	$17.78	$15.17	86
South Carolina	14,688	$17.03	$14.57	65
Alabama	12,916	$17.69	$15.59	80
Ohio	11,468	$18.04	$15.04	66
Virginia	11,213	$20.12	$15.42	107
North Carolina	10,974	$18.69	$15.25	75
Colorado	10,928	$19.12	$14.73	66
Nevada	10,834	$19.71	$15.64	42
Pennsylvania	10,659	$19.95	$15.63	91
Maryland	9,571	$21.73	$15.64	82
Arkansas	7,809	$17.48	$15.17	44
Louisiana	7,429	$16.87	$14.78	24
Michigan	6,760	$18.53	$14.98	55
Missouri	5,490	$18.51	$15.31	67
Minnesota	5,019	$19.62	$14.96	82
Kansas	4,756	$18.21	$15.28	36
Oklahoma	4,377	$17.51	$15.18	34
Utah	4,290	$16.78	$14.40	25
Nebraska	4,253	$18.11	$15.22	40
Indiana	4,016	$18.35	$15.40	53
Mississippi	3,410	$17.30	$15.17	22
Wisconsin	2,917	$18.26	$15.81	12
Washington	2,667	$20.50	$15.26	37
Iowa	2,657	$18.60	$15.45	31
Connecticut	1,767	$21.07	$15.46	17
Delaware	1,391	$18.74	$14.34	10
Oregon	1,271	$20.41	$15.36	20
Puerto Rico	1,166	$19.97	$15.56	4
New Mexico	1,134	$17.46	$14.70	12
South Dakota	1,025	$19.74	$15.63	5
Wyoming	887	$19.65	$15.06	6
Maine	867	$19.59	$15.40	8
Massachusetts	761	$18.79	$14.87	11
Idaho	601	$17.53	$14.92	4
North Dakota	594	$19.32	$14.28	4
Alaska	422	$18.40	$15.32	6
New Hampshire	267	$19.94	$15.76	2
Vermont	244	$21.17	$15.74	2
Kentucky	186	$18.05	$15.01	4
West Virginia	101	$19.78	$15.74	2
Rhode Island	87	$20.92	$15.84	2
XX	84	$18.68	$16.07	1
Guam	75	$21.54	$15.45	1
Hawaii	70	$22.03	$14.97	1
District of Columbia	19	$20.75	$15.86	1

Related codes

96372Injection of drug or substance under skin or into muscle$13.42
96375Injection of additional new drug or substance into vein$14.96
96365Infusion into a vein for therapy$60.47
96367Infusion into a vein for therapy$27.64
96361Infusion into a vein for hydration$12.46
96360Infusion into a vein for hydration$32.19
96374Injection of drug or substance into vein$36.97
96368Infusion into a vein for therapy$19.10
96377Application of on-body injector for under skin injection$18.64
96369Infusion into tissue for therapy or prevention$137.17
96370Infusion into tissue for therapy or prevention$15.36
96373Injection of drug or substance into artery$18.66

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.