96415
ActiveAdd-on codeChemo iv infusion addl hr
96415 is an add-on code — it is only payable alongside a primary procedure: 96413.
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 96415 | 1 | $28.39 | $28.39 |
| add-on96368 | 0 | $20.71/ unit | $20.71/ unit |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 96415 | 0.19 | 0.64 | 0.64 | 0.02 | 0.85 |
Payment policy for 96415
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=5Incident-to
Covered when furnished by staff under direct physician supervision (not in hospital settings).
Multiple procedures
mult_surg=0No reduction
No multiple-procedure payment adjustment applies (typical for add-on codes).
Bilateral (modifier 50)
bilt_surg=0150% rule doesn't apply
Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).
Assistant surgeon (80/81/82)
asst_surg=0Payable with documentation
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Co-surgeons (modifier 62)
co_surg=0Not permitted
Co-surgeons (mod 62) may not be paid for this procedure.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.