{
    "code": "96365",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/96365/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/96365/2018/C",
    "description": "The first drip infusion of a drug or fluid into a vein for treatment, prevention, or diagnosis, covering up to about an hour of infusion time. It takes in starting the line, assessing the patient, preparing and hanging the bag, and monitoring during the infusion. Only one substance in an encounter is treated as the initial one - later drugs and extra hours in the same visit are recorded with their own companion codes. Chemotherapy and similarly complex biologic infusions are recorded under a different family instead.",
    "answer": {
        "question": "How much did Medicare pay for CPT 96365 in Q3 2018?",
        "text": "Medicare paid $74.16 for CPT 96365 in the office (non-facility) setting and $74.16 in a facility under the Q3 2018 Physician Fee Schedule, effective July 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it increased 6.0%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "C",
        "label": "Q3 2018",
        "effective": "July 1 – September 30, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 74.16,
        "facility": 74.16,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.21,
        "practice_expense_non_facility": 1.81,
        "practice_expense_facility": 1.81,
        "malpractice": 0.04
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q3 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18c1.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/C",
        "file": "PPRRVU18_JUL.csv",
        "row": 16317,
        "sha256": "514e3c115f8e62a35eb5f78fef7ed12ed7b60b22a5fe3f3f1bb5aadf119663c5"
    },
    "modified_at": "2026-08-04T03:08:27+00:00"
}