{
    "code": "96401",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/96401/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/96401/2020/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 2020?",
        "text": "Medicare paid $80.12 for CPT 96401 in the office (non-facility) setting and $80.12 in a facility under the Q1 2020 Physician Fee Schedule, effective January 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.8% decrease from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "A",
        "label": "Q1 2020",
        "effective": "January 1 – March 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 80.12,
        "facility": 80.12,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.21,
        "practice_expense_non_facility": 1.96,
        "practice_expense_facility": 1.96,
        "malpractice": 0.05
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q1 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20a-updated-01312020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/A",
        "file": "PPRRVU20_Jan.csv",
        "row": 16878,
        "sha256": "28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d"
    },
    "modified_at": "2026-08-04T03:09:22+00:00"
}