CPT code 96523: Port irrigation, implanted drug-delivery access device2026 Medicare rate & RVUs

Medicare pays $26.05 for 96523 nationally in the office. Local office rates run $22.45–$36.82.

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

What 96523 covers

This service covers irrigation or flushing of an implanted venous access device used to deliver drugs, such as an implanted port. Clinical staff typically perform it in an office or outpatient setting as ongoing device maintenance, rather than to refill a medication pump or administer a drug. The work centers on accessing and irrigating the device; it is not port placement or removal.

Select the code when documentation supports irrigation of the implanted access device, not refill or maintenance of a portable or implanted pump. The record should identify the device and describe the irrigation performed. CMS treats this as an injection or minor service and pays it only when no other physician service is billed on the same date. It is an incident-to service, so it 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 96523 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

96523 rates by state

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

How the 96523 rate is calculated

Each of 96523’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 96523

The CMS indicators that decide how 96523 is paid alongside other services.

96523 compared with similar codes

How to choose

96521Pump refillPortable infusion pump

Choose 96521 for refill or maintenance of a portable pump. Choose 96523 for irrigation of an implanted venous access device.

96522Pump refillImplantable systemic delivery

Choose 96522 for refill or maintenance of an implanted pump or reservoir; 96523 is for irrigation of an implanted venous access device.

36591Port blood drawImplantable venous access device

36591 describes collection of a blood specimen from a completely implantable venous access device. It does not describe irrigation or flushing of that device.

Codes related to 96523

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