CPT 96367: Additional IV Infusion of Different Medication, Up to 1 Hour
Medicare pays $31 and commercial payers pay $78 on average nationally for this procedure.
CPT code 96367 describes administration of an additional intravenous infusion of a different medication or substance, given after an initial infusion, for up to one hour to prevent, treat, or diagnose a condition; this represents an additional IV infusion service typically performed in an outpatient infusion clinic or hospital infusion suite and is billed as a separate infusion service following the primary infusion.
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National Reimbursement Benchmarks
Medicare's mean rate of $31 sits well below BUCA's average commercial mean of $77.5, indicating a substantial gap between federal reimbursement and that commercial benchmark. The median for Medicare is $30 (P25 $29, P75 $32), reflecting a tightly clustered Medicare locality distribution around its mean, while BUCA's P25 $52.1 and P75 $95.4 suggest higher commercial variability and overall pricing.
Comparing interquartile spreads (P75–P25) highlights dispersion differences: Blue Cross Blue Shield shows a spread of $52.1, Aetna $36.9, Cigna $32.2, UnitedHealth Group $28.7, and BUCA $43.3; Medicare's spread is $3. Note that Blue Cross Blue Shield and BUCA are among the widest, indicating broader commercial rate variability, whereas Medicare is the tightest by a large margin.