How much does Medicare pay for CPT 96375?

Medicare allowed an average of $14.96 per service and paid $11.82 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $81.63, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96375?

Injection of additional new drug or substance into vein. It was billed 1,301,323 times to 253,028 Medicare beneficiaries by 5,231 providers in 2024.

Which specialty bills 96375 most?

Hematology-Oncology, with 738,110 services from 2,315 clinicians. Next are Medical Oncology, Rheumatology, Nurse Practitioner.

CPT 96375

Injection of additional new drug or substance into vein

$14.96Medicare-allowed amount per service, averaged across 1,301,323 services

Providers submitted

$81.63

Asking price, not received

Medicare allowed

$14.96

The fee schedule figure

Medicare paid

$11.82

Balance is patient coinsurance

Providers submitted an average of $81.63 for this code and Medicare allowed $14.96 — 5.5× 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 $11.82 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,301,323
Beneficiaries: 253,028
Providers billing it: 5,231
Total allowed: $19,467,792

What Medicare pays for CPT 96375

Across 1,301,323 services billed by 5,231 providers to 253,028 beneficiaries, Medicare allowed an average of $14.96 per service. That is 5.1 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 96375

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	738,110	138,279	$15.05	2,315
Medical Oncology	199,577	44,085	$15.07	801
Rheumatology	71,417	17,404	$14.95	590
Nurse Practitioner	61,063	11,851	$12.53	480
Internal Medicine	53,627	10,239	$15.30	235
Family Practice	39,371	3,414	$15.57	90
Hematology	18,583	3,337	$15.57	68
Neurology	17,896	3,178	$14.79	129
Physician Assistant	14,511	3,393	$13.20	112
Gynecological Oncology	12,617	1,693	$14.77	53
General Practice	10,347	309	$15.27	5
Nuclear Medicine	8,212	1,385	$17.07	3
Infectious Disease	7,035	1,136	$14.74	40
Emergency Medicine	6,023	2,441	$16.09	91
Cardiology	5,681	3,896	$15.90	49

96375 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
Florida	174,225	$14.70	$11.82	527
California	166,736	$17.12	$11.80	501
Texas	121,769	$14.44	$11.85	628
Illinois	80,604	$14.71	$11.71	280
Virginia	67,990	$14.89	$11.71	173
Arizona	52,906	$14.56	$11.79	209
New York	49,103	$16.24	$11.77	263
Maryland	46,270	$16.18	$11.85	146
Pennsylvania	39,219	$15.47	$11.89	155
Alabama	34,587	$13.26	$11.76	102
New Jersey	32,270	$16.70	$11.79	137
Arkansas	31,236	$13.21	$11.83	61
Tennessee	30,116	$13.45	$11.63	174
Ohio	26,830	$13.95	$11.75	141
South Carolina	26,664	$13.50	$11.47	118
Minnesota	26,449	$15.44	$11.83	158
Nevada	24,674	$14.95	$11.70	60
Michigan	21,162	$14.48	$11.77	118
North Carolina	17,811	$14.10	$11.70	139
Colorado	17,656	$15.00	$11.40	98
Georgia	17,056	$13.80	$11.79	114
Nebraska	16,345	$13.78	$11.79	52
Washington	15,510	$15.49	$11.75	73
Missouri	15,510	$13.97	$11.81	111
Indiana	15,024	$13.74	$11.81	69
Oregon	13,516	$15.39	$11.71	68
Oklahoma	13,101	$12.74	$11.40	55
Kansas	12,487	$13.18	$11.33	45
Mississippi	12,432	$13.44	$11.91	35
Iowa	12,427	$13.96	$11.86	56
Louisiana	9,826	$13.49	$11.71	41
Wisconsin	8,087	$14.04	$11.71	46
New Mexico	7,702	$14.08	$11.84	39
Massachusetts	5,441	$15.81	$11.66	33
Delaware	4,233	$15.42	$11.66	16
Maine	4,189	$14.86	$11.86	15
Idaho	3,721	$13.82	$11.57	12
Connecticut	3,569	$16.01	$11.51	24
Kentucky	3,410	$13.34	$11.72	20
Alaska	3,388	$16.48	$11.56	17
Utah	3,383	$13.96	$11.78	38
North Dakota	3,065	$14.89	$11.33	6
South Dakota	2,638	$14.81	$11.70	8
New Hampshire	1,420	$15.52	$11.79	10
Wyoming	1,162	$15.15	$11.61	9
Vermont	1,160	$15.31	$11.87	3
West Virginia	696	$14.28	$11.95	4
District of Columbia	684	$17.17	$11.96	5
Guam	670	$16.39	$11.92	3
Rhode Island	587	$16.39	$11.95	3
Hawaii	248	$15.80	$11.31	5
U.S. Virgin Islands	158	$13.46	$12.31	1
Montana	145	$14.56	$11.61	4
XX	25	$14.35	$10.94	1
ZZ	19	$10.29	$10.59	1
AP	12	$17.78	$12.01	1

Related codes

96372Injection of drug or substance under skin or into muscle$13.42
96365Infusion into a vein for therapy$60.47
96367Infusion into a vein for therapy$27.64
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.