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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 96401
  4. Cost Analysis

How Much Does Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle Cost on Medicare?

Cost analysis for CPT 96401 — Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

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Average Medicare Payment

$55.92

2023 data

Total Payments (2023)

$39.4M

Services (2023)

694.0K

Price Change (2014–2023)

-1.0%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$56.51$28.5M498.2K—
2015$57.55$32.6M559.9K+1.8%
2016$57.20$34.2M592.3K-0.6%
2017$56.91$31.8M551.9K-0.5%
2018$61.07$33.7M544.2K+7.3%
2019$61.21$36.3M585.7K+0.2%
2020$61.19$36.5M590.2K-0.0%
2021$63.37$37.8M587.0K+3.6%
2022$58.99$34.3M572.3K-6.9%
2023$55.92$39.4M694.0K-5.2%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.5x more than the cheapest for this procedure. DC averages $66.53 vs HI at $44.97.

StateAvg PaymentTotal PaymentsServicesProviders
DC$66.53$129.1K1.9K9
CA$65.80$3.0M44.9K208
NY$65.38$1.5M23.4K161
NJ$63.45$2.7M43.3K215
MD$63.25$2.3M36.7K185
AK$62.85$56.0K8919
CT$62.53$77.9K1.2K14
MA$61.47$304.3K5.0K20
CO$59.20$655.6K11.1K87
VA$58.82$2.1M34.9K179
RI$58.72$42.1K7172
WA$58.24$203.4K3.5K37
SD$57.99$13.5K2331
VT$57.82$26.8K4633
IL$57.65$1.1M19.4K165
PA$57.44$2.4M41.3K186
MN$57.17$303.0K5.3K81
ND$57.16$7.0K1221
NV$56.84$234.8K4.1K33
DE$56.12$532.5K9.5K29
OR$55.95$197.2K3.5K40
FL$55.78$7.5M133.6K585
GU$55.61$12.0K2161
PR$55.53$9.1K1642
TX$54.15$4.7M87.2K478
MI$54.03$443.4K8.2K77
NH$54.02$20.4K3774
WI$53.97$105.8K2.0K15
ME$53.69$43.0K8007
AZ$53.65$1.2M22.3K104
NC$53.21$753.7K14.2K79
GA$52.82$561.4K10.6K78
KS$52.50$253.2K4.8K28
NM$52.37$135.4K2.6K20
UT$52.30$204.8K3.9K15
SC$52.01$618.3K11.9K66
OH$51.99$449.6K8.6K64
MO$51.92$227.9K4.4K55
IA$51.87$324.0K6.2K44
ID$51.69$30.7K5945
LA$50.54$582.4K11.5K45
NE$50.15$351.1K7.0K32
OK$50.09$122.3K2.4K19
AL$50.05$381.6K7.6K60
IN$50.04$493.4K9.9K62
TN$49.78$722.7K14.5K105
AR$49.45$515.0K10.4K60
KY$48.36$257.0K5.3K18
WV$47.69$50.3K1.1K10
MS$46.71$449.4K9.6K63
HI$44.97$10.0K2221

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Vinicius Costa Diniz DominguesRheumatologyFL$287.9K5.2K$55.82
Nehal GandhiRheumatologyPA$192.1K3.1K$62.20
Elizabeth ClaytonRheumatologyMD$184.1K3.1K$60.28
Marc HirshRheumatologyFL$171.5K2.9K$59.30
Steven GolombekRheumatologyNJ$157.0K2.4K$65.95
Vipul JoshiRheumatologyFL$150.1K2.7K$55.06
Phong NguyenRheumatologyVA$138.0K2.2K$62.38
Victoria KatzRheumatologyNY$138.0K2.0K$68.44
Arash HorizonRheumatologyCA$116.7K1.7K$68.45
Claude Abujrab-SabaInternal MedicineVA$114.4K1.8K$63.71
Richard HaddadRheumatologyNJ$101.1K1.6K$64.21
William SunshineRheumatologyFL$98.6K1.7K$57.47
Vedashree PanthuluRheumatologyFL$94.9K1.7K$54.34
Mohamed AboyoussefRheumatologyFL$94.2K1.7K$55.21
Sean WollastonRheumatologyCA$92.9K1.5K$63.83
Suneet GrewalRheumatologyCA$90.4K1.2K$77.40
Seth CorenOrthopedic SurgeryFL$88.7K1.5K$59.40
Ahmed Abdel-MegidRheumatologyNJ$87.3K1.3K$65.47
Anthony BottiHematology-OncologyNJ$87.0K1.3K$67.36
Jyothi MallepalliRheumatologyLA$83.7K1.6K$51.30

🤔 Is Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle Overpriced?

Based on the data, CPT 96401 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.

Costs have decreased 1% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.