96371 Sc ther infusion reset pump
What 96371 is
CMS fee schedule short descriptor: Sc ther infusion reset pump.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 96371 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.00 | 1.69 | 0.00 | 1.69 | $56.45 |
| Facility (hospital, ASC) | 0.00 | 1.69 | 0.00 | 1.69 | $56.45 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 96371 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 96371? These codes are bundled into it
96371 is a Column 1 code in 7 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99358 | Prolong service w/o contact | 1 - modifier may bypass | Check pair |
99359 | Prolong serv w/o contact add | 1 - modifier may bypass | Check pair |
99418 | Prolng ip/obs e/m ea 15 min | 1 - modifier may bypass | Check pair |
E0781 | 1 - modifier may bypass | Check pair |
96371 is bundled into these codes
96371 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 96371 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0395T | Hdr elctr ntrst/ntrcv brchtx | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.