Add-on code for a sequential IV infusion of a different drug, up to one hour, given after the initial infusion through the same access.
- Medicare
- $29.73
- Work RVU
- 0.19
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Each drug name, dose, and J-code with units
- Start and stop time for each drug showing sequence
- Sequential infusion lasting more than 15 minutes
- Initial infusion or push code on the same claim
- Medical necessity for the second drug
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
96367 is for a second, different drug infused after the first one finishes, through the same IV line. It is an add-on and goes with an initial service such as 96365, 96374, or the chemotherapy initial codes. It is reported once per sequential drug, and each one has to run longer than 15 minutes.
An ortho infusion suite might hit this when a patient with a bone or joint infection gets two different IV antibiotics back to back, or when a premedication is infused before the main drug. The second drug is billed separately with its own J-code.
Common mistakes: billing 96367 for a second bag of the same drug (that is added time, 96366), billing it when the drugs ran at the same time (that is concurrent, 96368), or billing it as a second initial code. If the sequential infusion lasts 15 minutes or less, it is a sequential push, not 96367. Start and stop times for each drug need to be in the record so the sequence is clear.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.19) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.89) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.19 |
| Practice expense RVU | 0.69 |
| Malpractice RVU | 0.01 |
| Total RVU | 0.89 |
| Medicare national rate | $29.73 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $29.73 |
HOPD (APC 5692) Hospital outpatient department | $73.56 |
Common denial reasons
The recurring reasons claims for CPT 96367 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Same drug as the initial infusion
- Drugs infused at the same time (should be 96368)
- No primary initial code on the claim
- Sequential infusion 15 minutes or less
- Missing times so sequence cannot be verified
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 96367 and 96368?
02Can 96367 be billed more than once?
03Can 96367 be used for a second bag of the same antibiotic?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe lists each drug with its own timing in order, so the note shows a true sequential infusion instead of a concurrent or repeat one.
See how Mira captures CPT 96367 documentation