How much does Medicare pay for CPT 96417?

Medicare allowed an average of $62.30 per service and paid $49.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $262.90, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 96417?

Administration of additional new drug or substance into vein, 1 hour or less. It was billed 290,805 times to 89,272 Medicare beneficiaries by 2,985 providers in 2024.

Which specialty bills 96417 most?

Hematology-Oncology, with 204,578 services from 1,972 clinicians. Next are Medical Oncology, Internal Medicine, Gynecological Oncology.

CPT 96417

Administration of additional new drug or substance into vein, 1 hour or less

$62.30Medicare-allowed amount per service, averaged across 290,805 services

Providers submitted

$262.90

Asking price, not received

Medicare allowed

$62.30

The fee schedule figure

Medicare paid

$49.51

Balance is patient coinsurance

Providers submitted an average of $262.90 for this code and Medicare allowed $62.30 — 4.2× 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 $49.51 (79%); the rest is the patient’s coinsurance and deductible.

Services: 290,805
Beneficiaries: 89,272
Providers billing it: 2,985
Total allowed: $18,117,152

What Medicare pays for CPT 96417

Across 290,805 services billed by 2,985 providers to 89,272 beneficiaries, Medicare allowed an average of $62.30 per service. That is 3.3 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 96417

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	204,578	60,721	$62.42	1,972
Medical Oncology	60,608	19,993	$62.33	672
Internal Medicine	8,998	3,138	$61.50	105
Gynecological Oncology	5,501	1,310	$61.15	54
Hematology	4,977	1,460	$65.07	45
Nurse Practitioner	2,602	1,113	$54.24	69
Physician Assistant	1,510	646	$55.40	31
Hematopoietic Cell Transplantation and Cellular Therapy	493	289	$60.02	7
Obstetrics & Gynecology	427	155	$63.52	7
Hospitalist	425	145	$71.94	5
Radiation Oncology	376	175	$60.33	11
Surgical Oncology	79	24	$73.10	1
Family Practice	49	13	$74.11	1
Hospice and Palliative Care	45	28	$60.31	1
Gastroenterology	43	11	$73.05	1

96417 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	34,631	$60.71	$49.51	304
Texas	34,304	$60.31	$49.50	394
California	33,427	$72.90	$49.29	303
Illinois	15,732	$61.49	$49.44	168
Virginia	13,909	$61.99	$49.49	135
Arizona	12,285	$60.64	$49.27	134
Maryland	11,039	$68.28	$49.65	88
Tennessee	10,048	$56.02	$49.20	106
New York	9,826	$69.06	$49.43	124
New Jersey	7,836	$70.44	$49.30	84
Arkansas	7,250	$53.99	$49.37	43
Pennsylvania	7,041	$63.95	$49.62	78
Alabama	6,785	$54.62	$49.53	58
Georgia	6,720	$56.12	$49.55	57
Ohio	5,908	$58.06	$49.48	70
Minnesota	5,782	$64.33	$49.36	98
Michigan	5,171	$60.45	$49.47	64
South Carolina	4,791	$58.87	$49.45	39
Nevada	4,349	$63.33	$49.27	40
Iowa	4,294	$56.67	$49.42	37
Kansas	4,230	$56.10	$48.95	21
Nebraska	4,227	$56.83	$49.51	37
North Carolina	3,933	$58.95	$49.43	46
Washington	3,848	$64.43	$49.29	44
Indiana	3,713	$56.90	$49.49	40
Missouri	3,698	$58.51	$49.00	68
Mississippi	3,378	$54.99	$49.45	21
Colorado	3,319	$64.59	$49.70	40
Oregon	2,853	$63.95	$49.12	44
New Mexico	2,095	$57.90	$49.71	25
Oklahoma	1,806	$56.30	$49.41	17
Louisiana	1,510	$55.10	$49.24	16
Alaska	1,500	$67.77	$48.13	17
Wisconsin	1,294	$58.78	$48.41	22
Utah	1,272	$58.20	$49.78	17
Delaware	1,060	$64.85	$49.65	10
Idaho	781	$58.40	$49.36	6
Connecticut	680	$68.04	$48.33	14
Maine	665	$61.81	$49.69	9
Massachusetts	633	$66.45	$48.96	12
Wyoming	558	$63.64	$48.32	3
Kentucky	461	$55.66	$48.76	6
Vermont	436	$63.61	$49.29	3
New Hampshire	422	$65.02	$49.72	7
South Dakota	392	$61.13	$49.20	3
North Dakota	308	$61.15	$46.93	4
Rhode Island	169	$68.62	$49.79	2
Hawaii	151	$70.01	$49.98	3
West Virginia	139	$58.85	$49.59	2
Guam	82	$68.96	$49.36	1
XX	64	$59.83	$49.76	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
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

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.