How much does Medicare pay for CPT 96411?

Medicare allowed an average of $52.81 per service and paid $41.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $226.93, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96411?

Administration of additional new drug or substance into vein using push technique. It was billed 66,535 times to 21,787 Medicare beneficiaries by 1,254 providers in 2024.

Which specialty bills 96411 most?

Hematology-Oncology, with 48,329 services from 887 clinicians. Next are Medical Oncology, Internal Medicine, Hematology.

CPT 96411

Administration of additional new drug or substance into vein using push technique

$52.81Medicare-allowed amount per service, averaged across 66,535 services

Providers submitted

$226.93

Asking price, not received

Medicare allowed

$52.81

The fee schedule figure

Medicare paid

$41.83

Balance is patient coinsurance

Providers submitted an average of $226.93 for this code and Medicare allowed $52.81 — 4.3× 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 $41.83 (79%); the rest is the patient’s coinsurance and deductible.

Services: 66,535
Beneficiaries: 21,787
Providers billing it: 1,254
Total allowed: $3,513,713

What Medicare pays for CPT 96411

Across 66,535 services billed by 1,254 providers to 21,787 beneficiaries, Medicare allowed an average of $52.81 per service. That is 3.1 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 96411

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	48,329	15,679	$52.51	887
Medical Oncology	13,768	4,520	$53.56	278
Internal Medicine	1,725	697	$52.49	42
Hematology	1,307	394	$55.68	20
Family Practice	425	79	$62.26	1
Physician Assistant	291	123	$45.28	8
Nurse Practitioner	219	54	$45.85	3
Hematopoietic Cell Transplantation and Cellular Therapy	118	85	$51.85	5
Gynecological Oncology	118	46	$50.92	3
Hospitalist	102	47	$60.40	3
Rheumatology	67	28	$46.34	1
Surgical Oncology	29	13	$62.33	1
Obstetrics & Gynecology	20	11	$53.14	1
Radiation Oncology	17	11	$56.09	1

96411 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	9,102	$51.54	$42.17	148
Texas	6,061	$51.19	$42.23	146
California	5,394	$63.56	$42.23	75
Illinois	3,891	$53.28	$42.17	70
Virginia	3,614	$54.10	$41.62	83
Arizona	3,233	$52.10	$41.86	71
Tennessee	2,620	$47.87	$41.31	48
Arkansas	2,488	$46.17	$42.20	36
New York	2,363	$56.54	$42.18	54
New Jersey	1,868	$59.90	$42.15	34
Maryland	1,859	$57.93	$42.18	38
Alabama	1,714	$46.71	$42.17	28
South Carolina	1,687	$50.54	$42.26	24
Pennsylvania	1,498	$55.37	$42.33	31
Nebraska	1,436	$49.04	$41.98	24
Kansas	1,389	$47.93	$41.61	18
Iowa	1,343	$48.40	$42.26	23
Colorado	1,326	$55.26	$41.88	33
Georgia	1,309	$48.31	$42.19	21
Ohio	1,201	$49.75	$42.00	23
Minnesota	1,117	$55.48	$42.21	39
Mississippi	1,108	$47.36	$42.54	13
Michigan	1,062	$52.03	$42.40	22
Missouri	909	$54.00	$41.98	15
Nevada	908	$52.47	$42.26	17
Indiana	795	$48.79	$42.34	12
Washington	720	$54.33	$41.72	15
North Carolina	693	$49.27	$42.05	17
Oregon	598	$53.50	$41.31	14
Oklahoma	441	$48.34	$41.96	10
Delaware	358	$55.92	$41.80	6
Alaska	350	$59.59	$40.65	8
Louisiana	268	$46.96	$42.21	4
Utah	263	$50.12	$42.32	3
Maine	250	$52.05	$42.59	5
South Dakota	243	$52.69	$42.08	3
Vermont	165	$54.50	$41.88	3
New Mexico	143	$50.34	$42.43	4
Kentucky	139	$45.79	$42.87	2
New Hampshire	127	$56.65	$42.53	2
North Dakota	116	$55.92	$41.73	2
Wisconsin	95	$52.20	$42.41	3
West Virginia	88	$50.24	$42.31	2
Massachusetts	87	$57.37	$41.88	2
Idaho	77	$50.13	$41.91	2
Rhode Island	19	$61.70	$42.39	1

Related codes

96413Administration of chemotherapy into vein$125.25
96401Administration of non-hormonal anti-neoplastic chemotherapy under skin$70.79
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
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

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.