96415

Administration of chemotherapy into vein, each additional hour

Medicare pricing data for 12,469 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Administration of chemotherapy into vein, each additional hour (HCPCS code 96415) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $27.78, but hospitals typically charge $126.76 — a 4.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $27.78, your out-of-pocket cost would be approximately $5.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$27.78
Average Hospital Charge
$126.76
Markup Ratio
4.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$126.76
Medicare Allowed$27.78
Medicare Payment$21.96

Hospitals charge 4.6x more than what Medicare allows for this procedure. Medicare actually pays $21.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$32$19547916+15.0%
California$32$1481,05768,208+14.7%
Alaska$32$260372,311+14.4%
New Jersey$31$14133623,268+12.4%
New York$31$14469332,510+10.0%
Maryland$31$16135622,448+9.8%
Massachusetts$30$1641357,003+8.5%
Connecticut$30$1741593,294+7.6%
Rhode Island$29$13817616+3.9%
Hawaii$29$629280+3.3%
Colorado$29$13024212,132+3.0%
Washington$29$1212609,903+2.9%
Vermont$28$1805444+2.4%
Virginia$28$13733522,121+2.3%
Pennsylvania$28$12953623,886+1.7%
New Hampshire$28$152451,186+1.2%
Illinois$28$15454728,752+0.7%
Delaware$28$124523,708+0.0%
Nevada$28$1241107,638-0.1%
Minnesota$28$13537210,832-0.1%
Wyoming$28$14520642-0.6%
Montana$28$8319869-1.0%
South Dakota$27$155251,175-1.2%
Oregon$27$1112058,591-1.3%
Florida$27$911,05672,629-1.5%
Arizona$27$12433221,597-3.0%
Maine$27$156361,437-3.4%
Texas$27$1251,25368,434-3.4%
Puerto Rico$27$44612,711-4.0%
Michigan$27$8434212,155-4.3%
Missouri$26$12128312,722-4.8%
North Dakota$26$8620688-5.6%
New Mexico$26$114714,219-6.4%
Georgia$26$15132413,941-6.4%
North Carolina$26$12548520,365-6.4%
Wisconsin$26$2011446,058-6.6%
Utah$26$80974,405-7.0%
Ohio$26$13238215,130-7.2%
Nebraska$26$831175,028-7.6%
Iowa$26$831167,021-7.8%
Kansas$26$13412412,681-7.9%
Indiana$26$1262119,869-8.1%
West Virginia$26$8716712-8.2%
Idaho$25$116322,093-9.2%
Louisiana$25$1301175,004-9.4%
South Carolina$25$13820415,223-9.5%
Alabama$25$10121211,894-10.2%
Kentucky$25$1061105,124-10.4%
Oklahoma$25$86928,147-10.8%
Tennessee$25$9438317,192-10.9%
Arkansas$24$10711711,335-12.3%
Mississippi$24$1181066,810-12.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber