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CPT code 11981: Drug implant insertion, non-biodegradable implant2026 Medicare rate & RVUs in Washington, DC area

Report 11981 for inserting a non-biodegradable drug delivery implant, such as a subdermal contraceptive implant placed in the upper arm.

CMS RVU26DEffective Oct 1, 2026One payment locality8.6K Medicare services in 2024

In Washington, DC area, Medicare pays $121.64 for 11981 in the office and $59.47 when it’s performed in a hospital or facility.

$121.64Office (non-facility)
$59.47Hospital or facility
+13.1%vs the national office rate ($107.55)

Check a contract rate as a % of Medicare · 11981 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 11981 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 11981 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 11981 covers

Code 11981 describes the procedure to place a non-biodegradable implant that releases medication over time. A common example is insertion of an etonogestrel contraceptive implant beneath the skin of the upper arm. The service is typically performed in an office or other outpatient setting by a physician or other qualified clinician. The implant product is distinct from the insertion procedure; for an etonogestrel contraceptive implant, the product may be reported with HCPCS code J7307 when applicable.

Report the insertion when the implant is placed, and document the medication or implant, insertion site, and completed procedure. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; 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 Washington, DC area compares for 11981

Across 109 of 109 payment localities, the office rate for 11981 runs from $95.20 in Arkansas to $136.42 in San Benito County, CA. Washington, DC area pays $121.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

11981 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$121.64
  2. Los Angeles, CA · California$118.33−$3.31
  3. Miami, FL · Florida$120.88−$0.76
  4. Chicago, IL · Illinois$117.21−$4.43
  5. Manhattan, NY · New York$124.31+$2.67
  6. Alaska · Alaska$127.06+$5.42
  7. Alabama · Alabama$96.57−$25.07

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

11981 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$95.20$49.87
ArizonaArizona$104.57$53.44
Bakersfield, CACalifornia$111.61$53.77
Chico, CACalifornia$111.02$53.18
El Centro, CACalifornia$111.05$53.21
Fresno, CACalifornia$111.02$53.18
Hanford, CACalifornia$111.02$53.18
Madera, CACalifornia$111.02$53.18

11981 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$95.20

$127.06

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

View every state and territory as a table
11981 office rate range by state
State / territoryOffice rate rangeLocalities
AK$127.061
AL$96.571
AR$95.201
AZ$104.571
CA$111.02–$136.4229
CO$110.521
CT$114.651
DC$121.641
DE$106.271
FL$108.29–$120.883
GA$102.04–$110.092
GU$113.291
HI$113.291
IA$97.931
ID$98.781
IL$105.98–$117.214
IN$99.311
KS$97.981
KY$99.911
LA$99.96–$104.762
MA$110.08–$120.612
MD$108.11–$121.643
ME$99.82–$104.392
MI$102.93–$110.142
MN$104.451
MO$98.61–$104.523
MS$96.901
MT$107.541
NC$100.771
ND$103.381
NE$98.301
NH$109.281
NJ$115.55–$120.522
NM$103.691
NV$106.441
NY$102.29–$127.935
OH$102.091
OK$99.201
OR$105.21–$113.392
PA$101.96–$112.172
PR$108.141
RI$109.591
SC$101.681
SD$102.891
TN$98.531
TX$101.34–$110.518
UT$103.031
VA$104.41–$121.642
VI$108.141
VT$103.451
WA$109.72–$122.532
WI$100.031
WV$102.261
WY$105.731

See 11981 in every payment locality

How the 11981 rate is calculated

Each of 11981’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 · 11981

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.11

1.11 RVUs× 1.000 GPCI

Practice expense1.90

1.90 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

3.2200

Conversion factor

$33.4009

Medicare rate

$107.55

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,393

Code
11981
Physician work
1.11
Practice expense
1.90
Malpractice
0.21

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 11981 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.11× 1.0541.1699
Practice expense1.90× 1.1782.2382
Malpractice0.21× 1.1130.2337
Total RVUs3.6419
Conversion factor× 33.4009

Office rate, Washington, DC area$121.64

Office: (1.11 × 1.054 + 1.9 × 1.178 + 0.21 × 1.113) × $33.4009 = $121.64

Facility: (1.11 × 1.054 + 0.32 × 1.178 + 0.21 × 1.113) × $33.4009 = $59.47

Open 11981 in the RVU calculator

Payment rules and modifiers for 11981

The CMS indicators that decide how 11981 is paid alongside other services.

CMS payment indicators · 11981

Drug implant insertion, non-biodegradable implant

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)0Not paid without supporting documentation.
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

11981 without 51 · national office

$107.55

Drug implant insertion, non-biodegradable implant

11981-51 · Second procedure: 50%

$53.78

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

Codes related to 11981

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11981
CodeHow it relatesOffice range, Washington, DC area
Often billed with
J7307Etonogestrel implant, implant and suppliesReports the etonogestrel contraceptive implant product when applicable with its insertion.No office rate
Same family
11980Hormone pellets, subcutaneous implantationInsertion code for hormone pellets rather than a non-biodegradable drug delivery implant.$108.95
11982Implant removal, removal onlyRemoval procedure for a drug implant device.$129.03
11983Drug implant, removal with replacementRemoval and reinsertion of a drug implant device.$161.93

How 11981 has changed in Washington, DC area

11981 · Office / nonfacility

$121.64

Effective 2026-10-01

The base rate is $9.95 higher than on 2025-10-01, moving from $111.69 to $121.64 (8.9%).

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

    $111.69changed to$121.64

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.14 changed to 1.11
    • Practice expense RVU 1.68 changed to 1.90
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $114.94changed to$111.69

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $113.06changed to$114.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $117.84changed to$113.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.67 changed to 1.68
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $122.01changed to$117.84

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.65 changed to 1.67
    • Malpractice RVU 0.22 changed to 0.20
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $124.73changed to$122.01

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.70 changed to 1.65
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $123.80changed to$124.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.60 changed to 1.70
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $167.87changed to$123.80

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 1.48 changed to 1.14
    • Practice expense RVU 2.31 changed to 1.60
    • Malpractice RVU 0.26 changed to 0.22
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $167.69changed to$167.87

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $165.69changed to$167.69

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.27 changed to 2.31
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $164.25changed to$165.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.24 changed to 2.27
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $166.17changed to$164.25

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.26 changed to 2.24
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $165.34changed to$166.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $158.60changed to$165.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.16 changed to 2.26
    • Malpractice RVU 0.23 changed to 0.27
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $157.83changed to$158.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.35 changed to 2.16
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $157.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$121.64$59.47RVU26D
2026-07-01$121.64$59.47RVU26C
2026-04-01$121.64$59.47RVU26B
2026-01-01$121.64$59.47RVU26A
2025-10-01$111.69$67.73RVU25D
2025-07-01$111.69$67.73RVU25C
2025-04-01$111.69$67.73RVU25B
2025-01-01$111.69$67.73RVU25A
2024-10-01$114.94$68.91RVU24D
2024-07-01$114.94$68.91RVU24C
2024-04-01$114.94$68.91RVU24B
2024-03-09$114.94$68.91RVU24AR
2024-01-01$113.06$67.78RVU24A
2023-10-01$117.84$70.53RVU23D
2023-07-01$117.84$70.53RVU23C
2023-04-01$117.84$70.53RVU23B
2023-01-01$117.84$70.53RVU23A
2022-10-01$122.01$73.25RVU22D
2022-07-01$122.01$73.25RVU22C
2022-04-01$122.01$73.25RVU22B
2022-01-01$122.01$73.25RVU22A
2021-10-01$124.73$73.83RVU21D
2021-07-01$124.73$73.83RVU21C
2021-04-01$124.73$73.83RVU21B
2021-01-01$124.73$73.83RVU21A
2020-10-01$123.80$75.33RVU20D
2020-07-01$123.80$75.33RVU20C
2020-04-01$123.80$75.33RVU20B
2020-01-01$123.80$75.33RVU20A
2019-10-01$167.87$96.22RVU19D
2019-07-01$167.87$96.22RVU19C
2019-04-01$167.87$96.22RVU19B
2019-01-01$167.87$96.22RVU19A
2018-10-01$167.69$96.11RVU18D
2018-07-01$167.69$96.11RVU18C
2018-04-01$167.69$96.11RVU18B
2018-01-01$167.69$96.11RVU18AR1
2017-10-01$165.69$95.63RVU17D
2017-07-01$165.69$95.63RVU17C
2017-04-01$165.69$95.63RVU17B
2017-01-01$165.69$95.63RVU17A
2016-10-01$164.25$94.79RVU16D
2016-07-01$164.25$94.79RVU16C
2016-04-01$164.25$94.79RVU16B
2016-01-01$164.25$94.79RVU16A
2015-10-01$166.17$96.02RVU15D
2015-07-01$166.17$96.02RVU15C
2015-04-01$165.34$95.55RVU15B
2015-01-01$165.34$95.55RVU15A
2014-10-01$158.60$92.29RVU14D
2014-07-01$158.60$92.29RVU14C
2014-04-01$158.60$92.29RVU14B
2014-01-01$158.60$92.29RVU14A
2013-10-01$157.83$88.54RVU13D
2013-07-01$157.83$88.54RVU13C
2013-04-01$157.83$88.54RVU13B
2013-01-01$157.83$88.54RVU13AR

Price 11981 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

11981 billing questions

How does 11981 differ from 11980?

11981 is for inserting a non-biodegradable drug delivery implant, such as an etonogestrel contraceptive implant. 11980 describes insertion of hormone pellets.

Should the implant product be reported separately?

The insertion procedure and the drug implant product are distinct. For an etonogestrel contraceptive implant, HCPCS J7307 may report the product when applicable.

Is modifier 50 appropriate for two implants?

No. CMS identifies modifier 50 as inappropriate for 11981. Report the insertion service based on the procedure performed rather than billing it as a bilateral service.

What documentation supports 11981?

Document the implant or medication used, the insertion site, and that the implant was placed. For an upper-arm contraceptive implant, the record should support the completed insertion.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

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 11981PPRRVU2026_Oct_nonQPP.csv, line 1,393 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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