How much does Medicare pay for CPT 96367?

Medicare allowed an average of $27.64 per service and paid $21.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $121.05, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96367?

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less. It was billed 883,718 times to 178,891 Medicare beneficiaries by 3,990 providers in 2024.

Which specialty bills 96367 most?

Hematology-Oncology, with 555,013 services from 2,328 clinicians. Next are Medical Oncology, Infectious Disease, Internal Medicine.

CPT 96367

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

$27.64Medicare-allowed amount per service, averaged across 883,718 services

Providers submitted

$121.05

Asking price, not received

Medicare allowed

$27.64

The fee schedule figure

Medicare paid

$21.83

Balance is patient coinsurance

Providers submitted an average of $121.05 for this code and Medicare allowed $27.64 — 4.4× 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 $21.83 (79%); the rest is the patient’s coinsurance and deductible.

Services: 883,718
Beneficiaries: 178,891
Providers billing it: 3,990
Total allowed: $24,425,966

What Medicare pays for CPT 96367

Across 883,718 services billed by 3,990 providers to 178,891 beneficiaries, Medicare allowed an average of $27.64 per service. That is 4.9 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 96367

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	555,013	113,611	$27.89	2,328
Medical Oncology	160,416	37,204	$27.39	781
Infectious Disease	32,388	3,166	$27.61	102
Internal Medicine	30,700	6,960	$27.96	155
Nurse Practitioner	27,942	5,227	$23.14	223
Hematology	21,104	2,933	$30.13	61
Family Practice	18,019	1,157	$26.70	27
Gynecological Oncology	9,339	1,915	$27.24	58
Rheumatology	6,963	1,722	$28.69	72
Physician Assistant	5,840	1,601	$23.41	60
Neurology	2,335	545	$26.97	27
Physical Medicine and Rehabilitation	2,230	230	$28.84	3
Emergency Medicine	1,787	226	$30.90	10
Radiation Oncology	1,645	578	$27.43	26
Hospitalist	1,287	368	$30.98	10

96367 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	119,704	$26.80	$21.93	552
Florida	111,022	$27.03	$21.89	433
California	89,057	$31.96	$21.87	392
Illinois	41,800	$26.93	$21.53	222
New Jersey	41,204	$31.23	$21.95	131
New York	40,674	$29.53	$21.84	187
Tennessee	37,422	$25.18	$21.49	154
Maryland	32,707	$30.90	$21.86	105
Arizona	28,982	$26.92	$21.61	149
Virginia	27,146	$27.83	$21.62	153
Georgia	25,921	$25.70	$21.91	78
Pennsylvania	22,554	$28.14	$21.98	106
Kansas	21,107	$24.83	$21.23	35
Alabama	21,023	$24.87	$21.73	83
Arkansas	19,156	$24.57	$21.79	47
Ohio	17,089	$26.04	$21.72	93
South Carolina	15,781	$26.38	$21.99	47
Iowa	15,734	$25.57	$21.79	54
Colorado	14,509	$28.09	$21.15	75
Michigan	13,808	$26.61	$21.83	75
North Carolina	12,252	$26.40	$21.59	64
Mississippi	9,668	$25.20	$21.86	25
Nebraska	9,640	$25.73	$21.80	41
Missouri	8,960	$26.06	$21.68	86
Indiana	8,769	$25.79	$21.80	49
Minnesota	7,211	$28.38	$21.99	104
Washington	6,822	$28.91	$21.61	54
Nevada	6,797	$27.25	$21.41	52
Oklahoma	6,781	$25.31	$21.73	21
Utah	6,667	$25.77	$21.89	33
New Mexico	6,267	$25.57	$22.06	30
Louisiana	5,618	$25.22	$21.78	34
Oregon	5,097	$28.72	$21.63	49
Connecticut	2,867	$30.89	$21.88	21
Alaska	2,790	$30.37	$21.47	18
Vermont	2,377	$29.67	$22.07	3
Kentucky	2,250	$24.77	$21.90	20
Delaware	2,180	$28.74	$21.63	11
Wisconsin	1,901	$26.10	$21.63	23
Wyoming	1,897	$27.76	$21.40	5
Idaho	1,883	$25.55	$21.22	10
Massachusetts	1,852	$29.46	$21.91	20
New Hampshire	1,033	$28.89	$22.05	7
Puerto Rico	992	$27.08	$21.70	3
North Dakota	844	$26.75	$20.37	5
Hawaii	817	$30.94	$21.67	4
Maine	787	$27.62	$22.06	11
U.S. Virgin Islands	683	$28.73	$21.68	2
South Dakota	549	$27.57	$21.68	3
XX	410	$26.61	$22.10	1
West Virginia	325	$26.54	$22.08	3
Guam	134	$30.19	$22.21	2
Rhode Island	132	$27.53	$22.09	3
District of Columbia	50	$32.28	$22.14	1
AP	16	$32.73	$22.18	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
96366Infusion into a vein for therapy$19.49
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.