CPT 96401

Across 804,941 services billed by 4,196 providers to 196,525 beneficiaries, Medicare allowed an average of $70.79 per service. That is 4.1 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.

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.

• 96413Administration of chemotherapy into vein$125.25
• 96415Administration of chemotherapy into vein$26.93
• 96417Administration of additional new drug or substance into vein$62.30
• 96402Administration of hormonal anti-neoplastic chemotherapy under skin or$34.55
• 96411Administration of additional new drug or substance into vein$52.81
• 96405Administration of chemotherapy into growth$68.35
• 96409Administration of chemotherapy into vein$99.73
• 96416Administration of prolonged chemotherapy into vein$130.62
• 96450Administration of chemotherapy into fluid-filled space between the tis$71.36

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 →