CPT code 11980: Hormone pellets, subcutaneous implantation2026 Medicare rate & RVUs in Rhode Island

Report this service when a clinician places hormone pellets beneath the skin, commonly for pellet-based hormone therapy such as testosterone replacement.

CMS RVU26DEffective Oct 1, 2026One payment locality25.6K Medicare services in 2024

In Rhode Island, Medicare pays $98.51 for 11980 in the office and $48.82 when it’s performed in a hospital or facility.

$98.51Office (non-facility)
$48.82Hospital or facility
+2.1%vs the national office rate ($96.53)

Check a contract rate as a % of Medicare · 11980 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11980 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 11980 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11980 covers

A clinician places one or more hormone pellets into subcutaneous tissue through a small incision or insertion site. This is commonly performed in an office by clinicians providing hormone therapy, including gynecologists, urologists, endocrinologists, and other qualified providers. The upper buttock or hip region is a typical site. The pellets provide a sustained hormone source after placement; this code represents the implantation procedure, not a skin injection or insertion of a contraceptive capsule.

Report the service for the implantation encounter, documenting the hormone product, number of pellets, insertion site, and procedure performed. The code describes pellet implantation rather than a separate unit for each pellet. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Rhode Island compares for 11980

Across 109 of 109 payment localities, the office rate for 11980 runs from $86.23 in Arkansas to $122.79 in San Benito County, CA. Rhode Island pays $98.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

11980 in Rhode Island vs other payment areas
  1. Rhode Island · this page$98.51
  2. Los Angeles, CA · California$106.52+$8.01
  3. Washington, DC area · District of Columbia$108.95+$10.44
  4. Miami, FL · Florida$106.48+$7.97
  5. Chicago, IL · Illinois$103.55+$5.04
  6. Manhattan, NY · New York$110.79+$12.28
  7. Alaska · Alaska$115.77+$17.26

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

11980 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$87.38$45.30
ArkansasArkansas$86.23$44.92
ArizonaArizona$94.08$47.47
Bakersfield, CACalifornia$100.60$47.89
Chico, CACalifornia$100.17$47.45
El Centro, CACalifornia$100.19$47.48
Fresno, CACalifornia$100.17$47.45
Hanford, CACalifornia$100.17$47.45

11980 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$86.23

$115.77

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11980 office rate range by state
State / territoryOffice rate rangeLocalities
AK$115.771
AL$87.381
AR$86.231
AZ$94.081
CA$100.17–$122.7929
CO$99.431
CT$102.591
DC$108.951
DE$95.531
FL$96.59–$106.483
GA$91.47–$98.542
GU$102.061
HI$102.061
IA$88.771
ID$89.431
IL$94.50–$103.554
IN$89.881
KS$88.691
KY$89.911
LA$89.90–$93.922
MA$99.04–$108.262
MD$97.14–$108.953
ME$90.17–$94.182
MI$92.32–$98.012
MN$94.621
MO$88.70–$93.863
MS$87.471
MT$96.521
NC$90.981
ND$93.551
NE$89.121
NH$98.191
NJ$103.58–$108.052
NM$92.911
NV$95.751
NY$92.25–$113.655
OH$91.721
OK$89.441
OR$94.82–$102.012
PA$91.68–$100.432
PR$97.071
RI$98.511
SC$91.541
SD$93.201
TN$89.131
TX$91.15–$99.268
UT$92.671
VA$94.11–$108.952
VI$97.071
VT$93.501
WA$98.75–$110.062
WI$90.721
WV$91.381
WY$95.231

See 11980 in every payment locality

How the 11980 rate is calculated

Each of 11980’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11980

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.07

1.07 RVUs× 1.000 GPCI

Practice expense1.67

1.67 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

2.8900

Conversion factor

$33.4009

Medicare rate

$96.53

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,392

Code
11980
Physician work
1.07
Practice expense
1.67
Malpractice
0.15

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 11980 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0191.0903
Practice expense1.67× 1.0331.7251
Malpractice0.15× 0.8920.1338
Total RVUs2.9492
Conversion factor× 33.4009

Office rate, Rhode Island$98.51

Office: (1.07 × 1.019 + 1.67 × 1.033 + 0.15 × 0.892) × $33.4009 = $98.51

Facility: (1.07 × 1.019 + 0.23 × 1.033 + 0.15 × 0.892) × $33.4009 = $48.82

Open 11980 in the RVU calculator

Payment rules and modifiers for 11980

The CMS indicators that decide how 11980 is paid alongside other services.

CMS payment indicators · 11980

Hormone pellets, subcutaneous implantation

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11980 without 51 · national office

$96.53

Hormone pellets, subcutaneous implantation

11980-51 · Second procedure: 50%

$48.27

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 11980 has changed in Rhode Island

11980 · Office / nonfacility

$98.51

Effective 2026-10-01

The base rate is $4.82 higher than on 2025-10-01, moving from $93.69 to $98.51 (5.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $93.69changed to$98.51

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 1.58 changed to 1.67
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $96.42changed to$93.69

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $94.84changed to$96.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $98.24changed to$94.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.55 changed to 1.58
    • Malpractice RVU 0.17 changed to 0.15
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $98.07changed to$98.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.52 changed to 1.55
    • Malpractice RVU 0.12 changed to 0.17
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $100.30changed to$98.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.54 changed to 1.52
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $100.57changed to$100.30

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.46 changed to 1.54
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $100.66changed to$100.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.47 changed to 1.46
    • Malpractice RVU 0.12 changed to 0.13
    • Work GPCI 1.027 changed to 1.024
    • Practice expense GPCI 1.050 changed to 1.049
    • Malpractice GPCI 0.999 changed to 0.990

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $101.31changed to$100.66

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.49 changed to 1.47

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $98.99changed to$101.31

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.45 changed to 1.49
    • Work GPCI 1.025 changed to 1.027
    • Practice expense GPCI 1.052 changed to 1.050
    • Malpractice GPCI 0.879 changed to 0.999

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $97.80changed to$98.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.44 changed to 1.45
    • Work GPCI 1.022 changed to 1.025
    • Practice expense GPCI 1.053 changed to 1.052
    • Malpractice GPCI 0.759 changed to 0.879

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $98.16changed to$97.80

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $97.67changed to$98.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $107.77changed to$97.67

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 1.48 changed to 1.10
    • Practice expense RVU 1.22 changed to 1.44
    • Malpractice RVU 0.22 changed to 0.12
    • Work GPCI 1.020 changed to 1.022
    • Malpractice GPCI 0.973 changed to 0.759

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$107.77

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$98.51$48.82RVU26D
2026-07-01$98.51$48.82RVU26C
2026-04-01$98.51$48.82RVU26B
2026-01-01$98.51$48.82RVU26A
2025-10-01$93.69$54.03RVU25D
2025-07-01$93.69$54.03RVU25C
2025-04-01$93.69$54.03RVU25B
2025-01-01$93.69$54.03RVU25A
2024-10-01$96.42$55.61RVU24D
2024-07-01$96.42$55.61RVU24C
2024-04-01$96.42$55.61RVU24B
2024-03-09$96.42$55.61RVU24AR
2024-01-01$94.84$54.70RVU24A
2023-10-01$98.24$57.20RVU23D
2023-07-01$98.24$57.20RVU23C
2023-04-01$98.24$57.20RVU23B
2023-01-01$98.24$57.20RVU23A
2022-10-01$98.07$56.72RVU22D
2022-07-01$98.07$56.72RVU22C
2022-04-01$98.07$56.72RVU22B
2022-01-01$98.07$56.72RVU22A
2021-10-01$100.30$58.24RVU21D
2021-07-01$100.30$58.24RVU21C
2021-04-01$100.30$58.24RVU21B
2021-01-01$100.30$58.24RVU21A
2020-10-01$100.57$59.68RVU20D
2020-07-01$100.57$59.68RVU20C
2020-04-01$100.57$59.68RVU20B
2020-01-01$100.57$59.68RVU20A
2019-10-01$100.66$59.79RVU19D
2019-07-01$100.66$59.79RVU19C
2019-04-01$100.66$59.79RVU19B
2019-01-01$100.66$59.79RVU19A
2018-10-01$101.31$60.10RVU18D
2018-07-01$101.31$60.10RVU18C
2018-04-01$101.31$60.10RVU18B
2018-01-01$101.31$60.10RVU18AR1
2017-10-01$98.99$59.35RVU17D
2017-07-01$98.99$59.35RVU17C
2017-04-01$98.99$59.35RVU17B
2017-01-01$98.99$59.35RVU17A
2016-10-01$97.80$58.22RVU16D
2016-07-01$97.80$58.22RVU16C
2016-04-01$97.80$58.22RVU16B
2016-01-01$97.80$58.22RVU16A
2015-10-01$98.16$58.43RVU15D
2015-07-01$98.16$58.43RVU15C
2015-04-01$97.67$58.14RVU15B
2015-01-01$97.67$58.14RVU15A
2014-10-01$107.77$84.00RVU14D
2014-07-01$107.77$84.00RVU14C
2014-04-01$107.77$84.00RVU14B
2014-01-01$107.77$84.00RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11980 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

11980 billing questions

How is this different from 11981?

Use 11980 for hormone pellet implantation. Code 11981 describes insertion of a drug-delivery implant and is not the hormone-pellet code.

Should units be reported for each pellet?

The service is the implantation procedure; the code is not reported as one unit per pellet. Document the number of pellets placed.

Does the 0-day global period include same-day follow-up care?

Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

Can modifier 50 be used for pellets placed on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11980PPRRVU2026_Oct_nonQPP.csv, line 1,392 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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