CPT 96548
Global ZZZ ActiveNtraop hipec px ea add 30min
CPT 96548 Billing & Documentation Guide
CPT code 96548 (Ntraop hipec px ea add 30min) is classified under Infusion/Chemotherapy with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3, a non-facility practice expense RVU of 0.85, and a malpractice RVU of 0.69, a total non-facility RVU of 4.54 and facility RVU of 4.54. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $151.61, though rates vary from $134.5 to $193.24 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 96548, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify current NCCI edits before bundling with related codes.
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 96548 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 96548
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3 | 3 |
| Practice Expense RVU | 0.85 | 0.85 |
| Malpractice RVU | 0.69 | 0.69 |
| Total RVU | 4.54 | 4.54 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 96548
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $149.89 | $149.89 | $145.38 - $164.52 | 29 |
| Florida | $173.55 | $173.55 | $161.98 - $188.04 | 3 |
| Georgia | $155.02 | $155.02 | $153 - $157.03 | 2 |
| Illinois | $172.03 | $172.03 | $162.15 - $182.33 | 4 |
| Michigan | $159.3 | $159.3 | $152.14 - $166.46 | 2 |
| North Carolina | $141.42 | $141.42 | $141.42 - $141.42 | 1 |
| New York | $167.96 | $167.96 | $143.38 - $183.17 | 5 |
| Ohio | $149.35 | $149.35 | $149.35 - $149.35 | 1 |
| Pennsylvania | $153.55 | $153.55 | $148.04 - $159.06 | 2 |
| Texas | $150.11 | $150.11 | $147.12 - $160.91 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
Frequently Asked Questions, CPT 96548
What does CPT code 96548 mean? +
CPT code 96548 represents: Ntraop hipec px ea add 30min. It's in the Infusion/Chemotherapy category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 96548? +
The 2026 Medicare national average non-facility payment for CPT 96548 is $151.61. Rates range from $134.5 to $193.24 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 96548? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 96548? +
No NCCI PTP edits currently on file for this code.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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