CPT 96369

Subcutaneous Infusion Initial 1 Hr W/Pump Set-Up

CPT 96369 pays $144.96 in a non-facility setting and $144.96 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $125.16 in Arkansas to $169.85 in California, a 36% spread.

National non-facility rate

$144.96

Office and other outpatient settings

Facility rate
$144.96

Hospital and ASC settings

Highest state
$169.85

California

Lowest state
$125.16

Arkansas · 36% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $144.96
CPT 96369 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $144.96, national facility $144.96.
StateRate compared visuallyNon-facilityFacility
California
$169.85$169.85
District of Columbia
$169.83$169.83
Washington
$164.14$164.14
Hawaii
$163.30$163.30
New Jersey
$162.66$162.66
Massachusetts
$161.92$161.92
New York
$161.48$161.48
Alaska
$156.92$156.92
Connecticut
$155.86$155.86
Colorado
$153.59$153.59
Oregon
$152.07$152.07
Maryland
$150.95$150.95
New Hampshire
$150.45$150.45
Rhode Island
$149.50$149.50
Minnesota
$148.23$148.23
Puerto Rico
$146.45$146.45
Virgin Islands
$146.45$146.45
Florida
$146.36$146.36
Montana
$144.96$144.96
Nevada
$144.93$144.93
Wyoming
$144.70$144.70
North Dakota
$144.36$144.36
South Dakota
$144.29$144.29
Delaware
$143.25$143.25
Vermont
$143.10$143.10
Texas
$142.80$142.80
Virginia
$142.34$142.34
Pennsylvania
$142.28$142.28
Illinois
$141.28$141.28
Arizona
$140.57$140.57
Georgia
$138.87$138.87
Wisconsin
$138.51$138.51
Maine
$138.49$138.49
Michigan
$137.01$137.01
Utah
$136.64$136.64
North Carolina
$135.42$135.42
Indiana
$134.45$134.45
South Carolina
$134.40$134.40
Nebraska
$133.79$133.79
New Mexico
$133.79$133.79
Missouri
$133.67$133.67
Idaho
$133.48$133.48
Louisiana
$133.09$133.09
Ohio
$133.05$133.05
Iowa
$132.72$132.72
Tennessee
$132.03$132.03
Kansas
$131.32$131.32
Oklahoma
$130.08$130.08
Kentucky
$129.67$129.67
West Virginia
$127.45$127.45
Alabama
$127.41$127.41
Mississippi
$125.66$125.66
Arkansas
$125.16$125.16

Billed by 1 specialties

Commercial rates for 96369

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates