CPT code 96522: Pump refill, implantable systemic delivery2026 Medicare rate & RVUs

Medicare pays $125.25 for 96522 nationally in the office. Local office rates run $107.78–$176.17.

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

What 96522 covers

This service covers accessing an implanted drug-delivery pump or reservoir, replenishing its medication supply, and performing the associated maintenance. It is used for implanted systems delivering medication through routes such as intravenous or intra-arterial access; an oncology example is a hepatic artery infusion pump. A physician or clinical staff member may perform the work in an office setting, with billing subject to the physician-supervision requirement described below.

Choose this code for an implanted system delivering medication systemically, rather than a portable pump or a pump delivering medication into the spinal or brain spaces. Document the implanted device and delivery route, the refill and maintenance performed, the medication and amount placed in the reservoir, and relevant pump checks. Under the CMS rule, this is an incident-to service and may be billed only when performed under physician supervision.

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.

Where 96522 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

96522 rates by state

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

How the 96522 rate is calculated

Each of 96522’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.

Payment rules and modifiers for 96522

The CMS indicators that decide how 96522 is paid alongside other services.

96522 compared with similar codes

How to choose

96521Pump refillPortable infusion pump

Choose 96522 for an implanted systemic-delivery pump or reservoir. Choose 96521 when the medication is delivered by a portable pump.

96523Port irrigationImplanted drug-delivery access device

Code 96523 is for irrigation of an implanted venous access device. It does not describe replenishing an implanted medication pump reservoir.

62369Pump managementRefill and reprogramming

Use 62369 for refill and maintenance of an implanted pump delivering medication into spinal or brain spaces when reprogramming is not performed; 96522 is for systemic delivery.

62370Pump refillProfessional reprogramming

Use 62370 for spinal or brain infusion-pump refill and maintenance when reprogramming is performed. Code 96522 describes an implanted pump for systemic drug delivery.

Codes related to 96522

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

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

Open CMS sourceHow we calculate rates