CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 96413 RVU and Medicare Payment (2026)
Chemo iv infusion 1 hr — 0.28 work RVU, about $133.27 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.28
- PE RVU (non-facility)
- 3.64
- PE RVU (facility)
- 3.64
- MP RVU
- 0.07
- Office payment
- $133.27
- Facility payment
- $133.27
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 96413 in a non-facility setting with national GPCI: (0.28 + 3.64 + 0.07) × $33.4009 ≈ $133.27. The same code in a facility setting pays about $133.27 because facility PE RVU (3.64) replaces office PE RVU.
What changes by locality
GPCI moves 96413 non-facility payment from $114.99 to $186.95 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 96413?
0.28. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 96413 in 2026?
About $133.27 non-facility ($133.27 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (0.28) and malpractice RVU stay fixed; only practice expense changes (3.64 office vs 3.64 facility). That is the entire office-vs-facility payment gap.