Heme/Onc
Hematology / Oncology
Infusion-driven revenue dominates: chemotherapy administration codes are time-stratified and drug-type stratified, with strict hierarchy rules. Cognitive E/M with G2211 is critical for survivorship and chronic disease management.
Top billed codes
The codes that drive revenue in this specialty. Click any code for documentation requirements, modifiers, and pitfalls.
| Code | Description | wRVU | Total RVU | Medicare $ | |
|---|---|---|---|---|---|
| 99205 | Office o/p new hi 60 min New patient with severe, decompensated, or high-acuity disease. Complex consult-style new patient encounters. | 3.50 | 7.09 | $237 | Details → |
| 99215 | Office o/p est hi 40 min Severe exacerbation, decompensated chronic illness, decision regarding hospitalization, or extensive comorbidity management requiring high-risk decision-making. | 2.80 | 5.76 | $192 | Details → |
| G2211 | Complex e/m visit add on Add-on to office E/M (99202-99215) when you are the continuing focal point for all needed care (primary care) OR the ongoing care provider for a single serious/complex condition. | 0.33 | 0.52 | $17 | Details → |
| 96413 | Chemo IV infusion first hour Initial IV chemo infusion of the encounter, up to 1 hour. Add 96415 for each additional hour, 96417 for additional drugs. | 0.29 | 4.73 | $158 | Details → |
| 96415 | Chemo IV infusion, each addl hr Each additional hour of the same chemo drug. | 0.19 | 1.26 | $42 | Details → |
| 96417 | Chemo IV infusion, additional drug Sequential chemo infusion of a different drug after 96413. | 0.28 | 2.37 | $79 | Details → |
| 96409 | Chemo IV push, single drug IV push chemo. Use 96411 for each additional push of a different drug. | 0.28 | 3.28 | $110 | Details → |
| 96365 | Therapeutic IV infusion first hour First therapeutic non-chemo IV infusion at the encounter. | 0.21 | 2.04 | $68 | Details → |
| 96366 | Therapeutic IV infusion ea addl hour Each additional hour of the same therapeutic infusion. | 0.18 | 0.68 | $23 | Details → |
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Educational reference, not billing or legal advice. Coverage curated, not exhaustive. Verify against payer contracts.