{
    "code": "96401",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/96401/2016/A",
    "release_specific_url": "https://localishealth.com/cpt/96401/2016/A",
    "description": "Administration of a cancer-fighting drug as a single injection into the fatty tissue just under the skin or into a muscle, rather than through a drip into a vein. Although the injection itself takes moments, the service reflects the surrounding work: verifying the order and dose, handling a hazardous drug safely, assessing the patient before and after, and watching for immediate reactions. This entry is for non-hormonal anti-cancer agents; hormone-type anti-cancer injections and intravenous chemotherapy routes are recorded under separate codes.",
    "answer": {
        "question": "How much did Medicare pay for CPT 96401 in Q1 2016?",
        "text": "Medicare paid $75.19 for CPT 96401 in the office (non-facility) setting and $75.19 in a facility under the Q1 2016 Physician Fee Schedule, effective January 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.4% decrease from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "A",
        "label": "Q1 2016",
        "effective": "January 1 – March 31, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 75.19,
        "facility": 75.19,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.21,
        "practice_expense_non_facility": 1.84,
        "practice_expense_facility": 1.84,
        "malpractice": 0.05
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q1 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/A",
        "file": "PPRRVU16_V0122.csv",
        "row": 15962,
        "sha256": "e7973024293c4f8bd19119f0479a6b7bdc36435376c6b05a22fd3cd3cec5b13c"
    },
    "modified_at": "2026-08-04T03:06:29+00:00"
}