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

Reports refilling and maintaining an implanted pump or reservoir that delivers medication through a systemic route such as intravenous or intra-arterial access.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Utah, Medicare pays $118.06 for 96522 in the office.

$118.06Office (non-facility)
Not available in this settingHospital or facility
−5.7%vs the national office rate ($125.25)

Check a contract rate as a % of Medicare · 96522 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 96522 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 96522 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 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.

How Utah compares for 96522

Across 109 of 109 payment localities, the office rate for 96522 runs from $107.78 in Arkansas to $176.17 in San Benito County, CA. Utah pays $118.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

96522 in Utah vs other payment areas
  1. Utah · this page$118.06
  2. Los Angeles, CA · California$145.97+$27.91
  3. Washington, DC area · District of Columbia$146.53+$28.47
  4. Miami, FL · Florida$133.58+$15.52
  5. Chicago, IL · Illinois$128.91+$10.85
  6. Manhattan, NY · New York$145.85+$27.79
  7. Alaska · Alaska$135.24+$17.18

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

Every other payment area

96522 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$109.75—
ArkansasArkansas$107.78—
ArizonaArizona$121.32—
Bakersfield, CACalifornia$135.60—
Chico, CACalifornia$135.41—
El Centro, CACalifornia$135.43—
Fresno, CACalifornia$135.41—
Hanford, CACalifornia$135.41—

96522 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.

$107.78

$155.79

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

View every state and territory as a table
96522 office rate range by state
State / territoryOffice rate rangeLocalities
AK$135.241
AL$109.751
AR$107.781
AZ$121.321
CA$135.41–$176.1729
CO$132.241
CT$134.811
DC$146.531
DE$123.661
FL$121.33–$133.583
GA$113.18–$127.602
GU$140.151
HI$140.151
IA$113.991
ID$114.751
IL$116.49–$130.244
IN$115.591
KS$112.971
KY$112.191
LA$111.83–$118.732
MA$131.03–$147.772
MD$126.52–$146.533
ME$115.10–$123.352
MI$115.47–$122.802
MN$126.971
MO$109.20–$119.693
MS$108.531
MT$125.251
NC$116.641
ND$123.861
NE$114.871
NH$129.711
NJ$136.42–$144.402
NM$116.101
NV$124.981
NY$118.76–$149.615
OH$115.191
OK$112.331
OR$124.10–$137.632
PA$115.62–$130.582
PR$126.491
RI$128.961
SC$116.091
SD$123.701
TN$113.621
TX$114.66–$131.728
UT$118.061
VA$122.60–$146.532
VI$126.491
VT$122.941
WA$130.93–$151.492
WI$118.771
WV$111.081
WY$124.651

See 96522 in every payment locality

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.

How the rate is built · 96522

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.21

0.21 RVUs× 1.000 GPCI

Practice expense3.47

3.47 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.7500

Conversion factor

$33.4009

Medicare rate

$125.25

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,813

Code
96522
Physician work
0.21
Practice expense
3.47
Malpractice
0.07

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 96522 in Utah
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0000.2100
Practice expense3.47× 0.9403.2618
Malpractice0.07× 0.8980.0629
Total RVUs3.5347
Conversion factor× 33.4009

Office rate, Utah$118.06

Office: (0.21 × 1 + 3.47 × 0.94 + 0.07 × 0.898) × $33.4009 = $118.06

Open 96522 in the RVU calculator

Payment rules and modifiers for 96522

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

CMS payment indicators · 96522

Pump refill, implantable systemic delivery

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
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/technical5Incident-to service.

Codes related to 96522

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

Codes related to 96522
CodeHow it relatesOffice range, Utah
Used instead
96521Pump refill, portable infusion pumpRefill and maintenance of a portable pump rather than an implanted systemic-delivery pump.$135.33
62369Pump management, refill and reprogrammingRefill and maintenance for an implanted pump delivering medication into spinal or brain spaces, without reprogramming.$92.57
62370Pump refill, professional reprogrammingSpinal or brain infusion-pump refill and maintenance when reprogramming is performed.$93.02

How 96522 has changed in Utah

96522 · Office / nonfacility

$118.06

Effective 2026-10-01

The base rate is $16.51 higher than on 2025-10-01, moving from $101.55 to $118.06 (16.3%).

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

    $101.55changed to$118.06

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.08 changed to 3.47
    • Malpractice RVU 0.06 changed to 0.07
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $110.09changed to$101.55

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.25 changed to 3.08
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $108.30changed to$110.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $109.58changed to$108.30

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.20 changed to 3.25
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $115.34changed to$109.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.32 changed to 3.20
    • Malpractice RVU 0.09 changed to 0.07
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $120.47changed to$115.34

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.45 changed to 3.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $115.70changed to$120.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.15 changed to 3.45
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $114.58changed to$115.70

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.09 changed to 3.15
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $114.12changed to$114.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.08 changed to 3.09

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $108.15changed to$114.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.93 changed to 3.08
    • Malpractice RVU 0.08 changed to 0.09
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $106.60changed to$108.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.90 changed to 2.93
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $107.23changed to$106.60

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.92 changed to 2.90
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $106.69changed to$107.23

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $103.05changed to$106.69

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.84 changed to 2.92
    • Malpractice RVU 0.05 changed to 0.07
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $105.63changed to$103.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.10 changed to 2.84
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $105.63

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$118.06Not available in this settingRVU26D
2026-07-01$118.06Not available in this settingRVU26C
2026-04-01$118.06Not available in this settingRVU26B
2026-01-01$118.06Not available in this settingRVU26A
2025-10-01$101.55Not available in this settingRVU25D
2025-07-01$101.55Not available in this settingRVU25C
2025-04-01$101.55Not available in this settingRVU25B
2025-01-01$101.55Not available in this settingRVU25A
2024-10-01$110.09Not available in this settingRVU24D
2024-07-01$110.09Not available in this settingRVU24C
2024-04-01$110.09Not available in this settingRVU24B
2024-03-09$110.09Not available in this settingRVU24AR
2024-01-01$108.30Not available in this settingRVU24A
2023-10-01$109.58Not available in this settingRVU23D
2023-07-01$109.58Not available in this settingRVU23C
2023-04-01$109.58Not available in this settingRVU23B
2023-01-01$109.58Not available in this settingRVU23A
2022-10-01$115.34Not available in this settingRVU22D
2022-07-01$115.34Not available in this settingRVU22C
2022-04-01$115.34Not available in this settingRVU22B
2022-01-01$115.34Not available in this settingRVU22A
2021-10-01$120.47Not available in this settingRVU21D
2021-07-01$120.47Not available in this settingRVU21C
2021-04-01$120.47Not available in this settingRVU21B
2021-01-01$120.47Not available in this settingRVU21A
2020-10-01$115.70Not available in this settingRVU20D
2020-07-01$115.70Not available in this settingRVU20C
2020-04-01$115.70Not available in this settingRVU20B
2020-01-01$115.70Not available in this settingRVU20A
2019-10-01$114.58Not available in this settingRVU19D
2019-07-01$114.58Not available in this settingRVU19C
2019-04-01$114.58Not available in this settingRVU19B
2019-01-01$114.58Not available in this settingRVU19A
2018-10-01$114.12Not available in this settingRVU18D
2018-07-01$114.12Not available in this settingRVU18C
2018-04-01$114.12Not available in this settingRVU18B
2018-01-01$114.12Not available in this settingRVU18AR1
2017-10-01$108.15Not available in this settingRVU17D
2017-07-01$108.15Not available in this settingRVU17C
2017-04-01$108.15Not available in this settingRVU17B
2017-01-01$108.15Not available in this settingRVU17A
2016-10-01$106.60Not available in this settingRVU16D
2016-07-01$106.60Not available in this settingRVU16C
2016-04-01$106.60Not available in this settingRVU16B
2016-01-01$106.60Not available in this settingRVU16A
2015-10-01$107.23Not available in this settingRVU15D
2015-07-01$107.23Not available in this settingRVU15C
2015-04-01$106.69Not available in this settingRVU15B
2015-01-01$106.69Not available in this settingRVU15A
2014-10-01$103.05Not available in this settingRVU14D
2014-07-01$103.05Not available in this settingRVU14C
2014-04-01$103.05Not available in this settingRVU14B
2014-01-01$103.05Not available in this settingRVU14A
2013-10-01$105.63Not available in this settingRVU13D
2013-07-01$105.63Not available in this settingRVU13C
2013-04-01$105.63Not available in this settingRVU13B
2013-01-01$105.63Not available in this settingRVU13AR

Price 96522 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

96522 billing questions

How does this differ from 96521?

Use 96522 for an implanted pump or reservoir delivering medication systemically. Code 96521 describes refill and maintenance of a portable pump.

Can 96522 be used for an intrathecal pump refill?

No. For an implanted pump delivering medication into spinal or brain spaces, use the applicable spinal or brain infusion-pump refill code, such as 62369 or 62370.

What documentation supports 96522?

Record the implanted pump type and delivery route, the refill and maintenance performed, the medication and amount placed, and relevant pump checks.

Who may perform the service for Medicare billing?

The CMS rule identifies this as an incident-to service: it may be billed only when performed under physician supervision.

Is flushing an implanted venous access device the same service?

No. Irrigation of an implanted venous access device is distinct from refilling and maintaining an implanted pump; 96523 describes the irrigation service.

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 96522PPRRVU2026_Oct_nonQPP.csv, line 12,813 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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