96415
Chemotherapy infusion, each additional hour
Chemotherapy infusion, each additional hour is the #516 most-billed Medicaid procedure code, with $170.8M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $43.68. Costs vary widely — the 90th percentile is $281.61 per claim, 6.4× the median.
Total Paid
$170.8M
0.02% of all spending
Total Claims
1.3M
Providers
1K
Avg Cost/Claim
$134
National Cost Distribution
How much do providers bill per claim for 96415? Based on 995 providers billing this code nationally.
Median
$43.68
Average
$101.37
Std Dev
$142.48
Max
$1,121.76
Percentile Distribution (Cost per Claim)
50% of providers bill between $22.00 and $102.17 per claim for this code.
90% bill between $10.83 and $281.61.
Top 1% bill above $616.58.
About This Procedure
HCPCS code 96415 (Chemotherapy infusion, each additional hour) was billed by 1K providers across 1.3M claims, totaling $170.8M in Medicaid payments from 2018–2024. This code was used for 881K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$43.68
Providers Billing
995
National Spending
$170.8M
Avg/Median Ratio
2.32×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96415
| # | Provider | Total Paid |
|---|---|---|
| 1 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $5.6M |
| 2 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $5.1M |
| 3 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $4.6M |
| 4 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $4.4M |
| 5 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $4.3M |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $3.6M |
| 7 | Mount Sinai Hospital New York, NY · Ambulance | $3.6M |
| 8 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $3.5M |
| 9 | University Of Rochester Rochester, NY · General Acute Care Hospital | $3.1M |
| 10 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $3.1M |
| 11 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $3.1M |
| 12 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $2.8M |
| 13 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2.6M |
| 14 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $2.5M |
| 15 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $2.4M |
| 16 | 1376577247 | $2.3M |
| 17 | Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier | $2.0M |
| 18 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $1.9M |
| 19 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $1.8M |
| 20 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.8M |
Showing top 20 of 1K providers billing this code