CPT code 96523: Port irrigation, implanted drug-delivery access device2026 Medicare rate & RVUs in Colorado
Report this service when an implanted venous access device used for drug delivery is irrigated or flushed to maintain access-device function.
In Colorado, Medicare pays $27.56 for 96523 in the office.
Check a contract rate as a % of Medicare · 96523 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Colorado compares for 96523
Across 109 of 109 payment localities, the office rate for 96523 runs from $22.45 in Arkansas to $36.82 in San Benito County, CA. Colorado pays $27.56. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$27.56
- Los Angeles, CA · California$30.46+$2.90
- Washington, DC area · District of Columbia$30.50+$2.94
- Miami, FL · Florida$27.56
- Chicago, IL · Illinois$26.62−$0.94
- Manhattan, NY · New York$30.28+$2.72
- Alaska · Alaska$28.16+$0.60
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $22.86 | — |
| ArkansasArkansas | $22.45 | — |
| ArizonaArizona | $25.25 | — |
| Bakersfield, CACalifornia | $28.29 | — |
| Chico, CACalifornia | $28.26 | — |
| El Centro, CACalifornia | $28.26 | — |
| Fresno, CACalifornia | $28.26 | — |
| Hanford, CACalifornia | $28.26 | — |
| Madera, CACalifornia | $28.26 | — |
| Merced, CACalifornia | $28.26 | — |
| Modesto, CACalifornia | $28.26 | — |
| Napa, CACalifornia | $33.73 | — |
| Oxnard, CACalifornia | $30.40 | — |
| Redding, CACalifornia | $28.26 | — |
| Rest of CaliforniaCalifornia | $28.26 | — |
| Riverside, CACalifornia | $28.37 | — |
| Sacramento, CACalifornia | $29.92 | — |
| Salinas, CACalifornia | $29.82 | — |
| San Diego, CACalifornia | $30.72 | — |
| Marin County, CACalifornia | $36.00 | — |
| San Francisco, CACalifornia | $35.98 | — |
| San Benito County, CACalifornia | $36.82 | — |
| Santa Clara County, CACalifornia | $36.78 | — |
| San Luis Obispo, CACalifornia | $29.31 | — |
| Santa Cruz, CACalifornia | $31.17 | — |
| Santa Maria, CACalifornia | $29.98 | — |
| Santa Rosa, CACalifornia | $31.50 | — |
| Stockton, CACalifornia | $28.26 | — |
| Vallejo, CACalifornia | $33.71 | — |
| Visalia, CACalifornia | $28.26 | — |
| Yuba City, CACalifornia | $28.26 | — |
| ConnecticutConnecticut | $28.03 | — |
| DelawareDelaware | $25.73 | — |
| Fort Lauderdale, FLFlorida | $26.64 | — |
| Rest of FloridaFlorida | $25.15 | — |
| Atlanta, GAGeorgia | $26.51 | — |
| Rest of GeorgiaGeorgia | $23.48 | — |
| Hawaii, Guam, HIHawaii | $29.25 | — |
| IowaIowa | $23.78 | — |
| IdahoIdaho | $23.93 | — |
| East St. Louis, ILIllinois | $24.44 | — |
| Rest of IllinoisIllinois | $24.12 | — |
| Suburban Chicago, ILIllinois | $26.98 | — |
| IndianaIndiana | $24.10 | — |
| KansasKansas | $23.55 | — |
| KentuckyKentucky | $23.32 | — |
| New Orleans, LALouisiana | $24.66 | — |
| Rest of LouisianaLouisiana | $23.23 | — |
| Metropolitan Boston, MAMassachusetts | $30.80 | — |
| Rest of MassachusettsMassachusetts | $27.30 | — |
| Baltimore area, MDMaryland | $27.93 | — |
| Rest of MarylandMaryland | $26.33 | — |
| Rest of MaineMaine | $23.98 | — |
| Southern Maine, MEMaine | $25.71 | — |
| Detroit, MIMichigan | $25.43 | — |
| Rest of MichiganMichigan | $23.97 | — |
| MinnesotaMinnesota | $26.52 | — |
| Metropolitan Kansas City, MOMissouri | $24.56 | — |
| Metropolitan St. Louis, MOMissouri | $24.88 | — |
| Rest of MissouriMissouri | $22.68 | — |
| MississippiMississippi | $22.58 | — |
| MontanaMontana | $26.05 | — |
| North CarolinaNorth Carolina | $24.30 | — |
| North DakotaNorth Dakota | $25.85 | — |
| NebraskaNebraska | $23.97 | — |
| New HampshireNew Hampshire | $27.01 | — |
| Northern New JerseyNew Jersey | $30.06 | — |
| Rest of New JerseyNew Jersey | $28.38 | — |
| New MexicoNew Mexico | $24.10 | — |
| NevadaNevada | $26.02 | — |
| NYC suburbs and Long Island, NYNew York | $31.03 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $28.50 | — |
| Queens, NYNew York | $30.72 | — |
| Rest of New YorkNew York | $24.73 | — |
| OhioOhio | $23.93 | — |
| OklahomaOklahoma | $23.37 | — |
| Portland, OROregon | $28.70 | — |
| Rest of OregonOregon | $25.86 | — |
| Metropolitan Philadelphia, PAPennsylvania | $27.14 | — |
| Rest of PennsylvaniaPennsylvania | $24.03 | — |
| Puerto RicoPuerto Rico | $26.32 | — |
| Rhode IslandRhode Island | $26.85 | — |
| South CarolinaSouth Carolina | $24.15 | — |
| South DakotaSouth Dakota | $25.83 | — |
| TennesseeTennessee | $23.68 | — |
| Austin, TXTexas | $27.43 | — |
| Beaumont, TXTexas | $23.83 | — |
| Brazoria, TXTexas | $25.77 | — |
| Dallas, TXTexas | $25.92 | — |
| Fort Worth, TXTexas | $25.68 | — |
| Galveston, TXTexas | $25.84 | — |
| Houston, TXTexas | $26.02 | — |
| Rest of TexasTexas | $24.78 | — |
| UtahUtah | $24.56 | — |
| VirginiaVirginia | $25.54 | — |
| Virgin Islands, VIUnited States Virgin Islands | $26.32 | — |
| VermontVermont | $25.64 | — |
| Rest of WashingtonWashington | $27.28 | — |
| King County, WAWashington | $31.59 | — |
| WisconsinWisconsin | $24.80 | — |
| West VirginiaWest Virginia | $23.00 | — |
| WyomingWyoming | $25.97 | — |
96523 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.
$22.45
$32.54
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $28.16 | 1 |
| AL | $22.86 | 1 |
| AR | $22.45 | 1 |
| AZ | $25.25 | 1 |
| CA | $28.26–$36.82 | 29 |
| CO | $27.56 | 1 |
| CT | $28.03 | 1 |
| DC | $30.50 | 1 |
| DE | $25.73 | 1 |
| FL | $25.15–$27.56 | 3 |
| GA | $23.48–$26.51 | 2 |
| GU | $29.25 | 1 |
| HI | $29.25 | 1 |
| IA | $23.78 | 1 |
| ID | $23.93 | 1 |
| IL | $24.12–$26.98 | 4 |
| IN | $24.10 | 1 |
| KS | $23.55 | 1 |
| KY | $23.32 | 1 |
| LA | $23.23–$24.66 | 2 |
| MA | $27.30–$30.80 | 2 |
| MD | $26.33–$30.50 | 3 |
| ME | $23.98–$25.71 | 2 |
| MI | $23.97–$25.43 | 2 |
| MN | $26.52 | 1 |
| MO | $22.68–$24.88 | 3 |
| MS | $22.58 | 1 |
| MT | $26.05 | 1 |
| NC | $24.30 | 1 |
| ND | $25.85 | 1 |
| NE | $23.97 | 1 |
| NH | $27.01 | 1 |
| NJ | $28.38–$30.06 | 2 |
| NM | $24.10 | 1 |
| NV | $26.02 | 1 |
| NY | $24.73–$31.03 | 5 |
| OH | $23.93 | 1 |
| OK | $23.37 | 1 |
| OR | $25.86–$28.70 | 2 |
| PA | $24.03–$27.14 | 2 |
| PR | $26.32 | 1 |
| RI | $26.85 | 1 |
| SC | $24.15 | 1 |
| SD | $25.83 | 1 |
| TN | $23.68 | 1 |
| TX | $23.83–$27.43 | 8 |
| UT | $24.56 | 1 |
| VA | $25.54–$30.50 | 2 |
| VI | $26.32 | 1 |
| VT | $25.64 | 1 |
| WA | $27.28–$31.59 | 2 |
| WI | $24.80 | 1 |
| WV | $23.00 | 1 |
| WY | $25.97 | 1 |
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.
How the rate is built · 96523
RVUs × geographic indexes × conversion factor
Work0.04
0.04 RVUs× 1.000 GPCI
Practice expense0.73
0.73 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.7800
Conversion factor
$33.4009
Medicare rate
$26.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Colorado inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,814
- Code
- 96523
- Physician work
- 0.04
- Practice expense
- 0.73
- Malpractice
- 0.01
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.04 | × 1.012 | 0.0405 |
| Practice expense | 0.73 | × 1.064 | 0.7767 |
| Malpractice | 0.01 | × 0.781 | 0.0078 |
| Total RVUs | 0.8250 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Colorado$27.56
Office: (0.04 × 1.012 + 0.73 × 1.064 + 0.01 × 0.781) × $33.4009 = $27.56
Payment rules and modifiers for 96523
The CMS indicators that decide how 96523 is paid alongside other services.
CMS payment indicators · 96523
Port irrigation, implanted drug-delivery access device
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 5 | Incident-to service. |
How 96523 has changed in Colorado
96523 · Office / nonfacility
$27.56
Effective 2026-10-01
The base rate is $3.17 higher than on 2025-10-01, moving from $24.39 to $27.56 (13.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$24.39changed to$27.56
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.67 changed to 0.73
- Work GPCI 1.008 changed to 1.012
- Practice expense GPCI 1.053 changed to 1.064
- Malpractice GPCI 0.827 changed to 0.781
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$26.15changed to$24.39
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.70 changed to 0.67
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$25.73changed to$26.15
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$26.90changed to$25.73
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.71 changed to 0.70
- Work GPCI 1.005 changed to 1.008
- Practice expense GPCI 1.050 changed to 1.053
- Malpractice GPCI 0.797 changed to 0.827
January 1, 2023
RVU23A
$28.37changed to$26.90
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.73 changed to 0.71
- Malpractice RVU 0.02 changed to 0.01
- Work GPCI 1.001 changed to 1.005
- Practice expense GPCI 1.047 changed to 1.050
- Malpractice GPCI 0.767 changed to 0.797
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$30.06changed to$28.37
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.77 changed to 0.73
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$28.94changed to$30.06
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.72 changed to 0.77
- Work GPCI 1.000 changed to 1.001
- Practice expense GPCI 1.033 changed to 1.047
- Malpractice GPCI 0.905 changed to 0.767
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$28.24changed to$28.94
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.71 changed to 0.72
- Practice expense GPCI 1.018 changed to 1.033
- Malpractice GPCI 1.042 changed to 0.905
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$28.94changed to$28.24
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.73 changed to 0.71
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$25.50changed to$28.94
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.65 changed to 0.73
- Malpractice RVU 0.01 changed to 0.02
- Practice expense GPCI 1.015 changed to 1.018
- Malpractice GPCI 1.066 changed to 1.042
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$25.35changed to$25.50
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 1.011 changed to 1.015
- Malpractice GPCI 1.090 changed to 1.066
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$25.44changed to$25.35
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$25.32changed to$25.44
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$24.89changed to$25.32
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.64 changed to 0.65
- Practice expense GPCI 1.008 changed to 1.011
- Malpractice GPCI 0.981 changed to 1.090
Held through RVU15B.
January 1, 2014
RVU14A
$25.23changed to$24.89
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.69 changed to 0.64
- Practice expense GPCI 1.004 changed to 1.008
- Malpractice GPCI 0.872 changed to 0.981
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $25.23
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $27.56 | Not available in this setting | RVU26D |
| 2026-07-01 | $27.56 | Not available in this setting | RVU26C |
| 2026-04-01 | $27.56 | Not available in this setting | RVU26B |
| 2026-01-01 | $27.56 | Not available in this setting | RVU26A |
| 2025-10-01 | $24.39 | Not available in this setting | RVU25D |
| 2025-07-01 | $24.39 | Not available in this setting | RVU25C |
| 2025-04-01 | $24.39 | Not available in this setting | RVU25B |
| 2025-01-01 | $24.39 | Not available in this setting | RVU25A |
| 2024-10-01 | $26.15 | Not available in this setting | RVU24D |
| 2024-07-01 | $26.15 | Not available in this setting | RVU24C |
| 2024-04-01 | $26.15 | Not available in this setting | RVU24B |
| 2024-03-09 | $26.15 | Not available in this setting | RVU24AR |
| 2024-01-01 | $25.73 | Not available in this setting | RVU24A |
| 2023-10-01 | $26.90 | Not available in this setting | RVU23D |
| 2023-07-01 | $26.90 | Not available in this setting | RVU23C |
| 2023-04-01 | $26.90 | Not available in this setting | RVU23B |
| 2023-01-01 | $26.90 | Not available in this setting | RVU23A |
| 2022-10-01 | $28.37 | Not available in this setting | RVU22D |
| 2022-07-01 | $28.37 | Not available in this setting | RVU22C |
| 2022-04-01 | $28.37 | Not available in this setting | RVU22B |
| 2022-01-01 | $28.37 | Not available in this setting | RVU22A |
| 2021-10-01 | $30.06 | Not available in this setting | RVU21D |
| 2021-07-01 | $30.06 | Not available in this setting | RVU21C |
| 2021-04-01 | $30.06 | Not available in this setting | RVU21B |
| 2021-01-01 | $30.06 | Not available in this setting | RVU21A |
| 2020-10-01 | $28.94 | Not available in this setting | RVU20D |
| 2020-07-01 | $28.94 | Not available in this setting | RVU20C |
| 2020-04-01 | $28.94 | Not available in this setting | RVU20B |
| 2020-01-01 | $28.94 | Not available in this setting | RVU20A |
| 2019-10-01 | $28.24 | Not available in this setting | RVU19D |
| 2019-07-01 | $28.24 | Not available in this setting | RVU19C |
| 2019-04-01 | $28.24 | Not available in this setting | RVU19B |
| 2019-01-01 | $28.24 | Not available in this setting | RVU19A |
| 2018-10-01 | $28.94 | Not available in this setting | RVU18D |
| 2018-07-01 | $28.94 | Not available in this setting | RVU18C |
| 2018-04-01 | $28.94 | Not available in this setting | RVU18B |
| 2018-01-01 | $28.94 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $25.50 | Not available in this setting | RVU17D |
| 2017-07-01 | $25.50 | Not available in this setting | RVU17C |
| 2017-04-01 | $25.50 | Not available in this setting | RVU17B |
| 2017-01-01 | $25.50 | Not available in this setting | RVU17A |
| 2016-10-01 | $25.35 | Not available in this setting | RVU16D |
| 2016-07-01 | $25.35 | Not available in this setting | RVU16C |
| 2016-04-01 | $25.35 | Not available in this setting | RVU16B |
| 2016-01-01 | $25.35 | Not available in this setting | RVU16A |
| 2015-10-01 | $25.44 | Not available in this setting | RVU15D |
| 2015-07-01 | $25.44 | Not available in this setting | RVU15C |
| 2015-04-01 | $25.32 | Not available in this setting | RVU15B |
| 2015-01-01 | $25.32 | Not available in this setting | RVU15A |
| 2014-10-01 | $24.89 | Not available in this setting | RVU14D |
| 2014-07-01 | $24.89 | Not available in this setting | RVU14C |
| 2014-04-01 | $24.89 | Not available in this setting | RVU14B |
| 2014-01-01 | $24.89 | Not available in this setting | RVU14A |
| 2013-10-01 | $25.23 | Not available in this setting | RVU13D |
| 2013-07-01 | $25.23 | Not available in this setting | RVU13C |
| 2013-04-01 | $25.23 | Not available in this setting | RVU13B |
| 2013-01-01 | $25.23 | Not available in this setting | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
96523 billing questions
When should 96523 be used instead of 96522?
Use 96523 for irrigation of an implanted venous access device used for drug delivery. Use 96522 for refill or maintenance of an implanted pump or reservoir system.
Can 96523 be paid when another physician service is billed that day?
Under the CMS rule supplied for this code, payment is available only when no other physician service is billed on the same date.
What documentation supports 96523?
Document that the device is an implanted venous access device used for drug delivery and that irrigation or flushing was performed. The record should also support that the service was provided under physician supervision.
Does 96523 describe a medication pump refill?
No. It describes irrigation of an implanted access device; pump refill or maintenance is represented by a different code, depending on the pump.
Can a modifier make 96523 payable with another physician service?
A modifier does not override the CMS payment condition supplied for this code: payment is available only when no other physician service is billed on the same date.
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
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