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

Report this service when an implanted venous access device used for drug delivery is irrigated or flushed to maintain access-device function.

CMS RVU26DEffective Oct 1, 2026One payment locality105.9K Medicare services in 2024

In Washington, DC area, Medicare pays $30.50 for 96523 in the office.

$30.50Office (non-facility)
Not available in this settingHospital or facility
+17.1%vs the national office rate ($26.05)

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.

We’ll open 96523 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 96523 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 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 Washington, DC area 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. Washington, DC area pays $30.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

96523 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$30.50
  2. Los Angeles, CA · California$30.46−$0.04
  3. Miami, FL · Florida$27.56−$2.94
  4. Chicago, IL · Illinois$26.62−$3.88
  5. Manhattan, NY · New York$30.28−$0.22
  6. Alaska · Alaska$28.16−$2.34
  7. Alabama · Alabama$22.86−$7.64

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

Every other payment area

96523 in every other Medicare payment locality
Payment localityOfficeFacility
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—

96523 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.

$22.45

$32.54

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

View every state and territory as a table
96523 office rate range by state
State / territoryOffice rate rangeLocalities
AK$28.161
AL$22.861
AR$22.451
AZ$25.251
CA$28.26–$36.8229
CO$27.561
CT$28.031
DC$30.501
DE$25.731
FL$25.15–$27.563
GA$23.48–$26.512
GU$29.251
HI$29.251
IA$23.781
ID$23.931
IL$24.12–$26.984
IN$24.101
KS$23.551
KY$23.321
LA$23.23–$24.662
MA$27.30–$30.802
MD$26.33–$30.503
ME$23.98–$25.712
MI$23.97–$25.432
MN$26.521
MO$22.68–$24.883
MS$22.581
MT$26.051
NC$24.301
ND$25.851
NE$23.971
NH$27.011
NJ$28.38–$30.062
NM$24.101
NV$26.021
NY$24.73–$31.035
OH$23.931
OK$23.371
OR$25.86–$28.702
PA$24.03–$27.142
PR$26.321
RI$26.851
SC$24.151
SD$25.831
TN$23.681
TX$23.83–$27.438
UT$24.561
VA$25.54–$30.502
VI$26.321
VT$25.641
WA$27.28–$31.592
WI$24.801
WV$23.001
WY$25.971

See 96523 in every payment locality

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

Office or facility?

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 96523 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.04× 1.0540.0422
Practice expense0.73× 1.1780.8599
Malpractice0.01× 1.1130.0111
Total RVUs0.9132
Conversion factor× 33.4009

Office rate, Washington, DC area$30.50

Office: (0.04 × 1.054 + 0.73 × 1.178 + 0.01 × 1.113) × $33.4009 = $30.50

Open 96523 in the RVU calculator

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

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 96523

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

Codes related to 96523
CodeHow it relatesOffice range, Washington, DC area
Used instead
96521Pump refill, portable infusion pumpFor refill or maintenance of a portable infusion pump rather than irrigation of an implanted access device.$168.17
96522Pump refill, implantable systemic deliveryFor refill or maintenance of an implanted pump or reservoir system.$146.53

How 96523 has changed in Washington, DC area

96523 · Office / nonfacility

$30.50

Effective 2026-10-01

The base rate is $2.92 higher than on 2025-10-01, moving from $27.58 to $30.50 (10.6%).

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

    $27.58changed to$30.50

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.67 changed to 0.73
    • 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

    $29.57changed to$27.58

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.70 changed to 0.67

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $29.09changed to$29.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $31.06changed to$29.09

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.71 changed to 0.70
    • 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

    $33.58changed to$31.06

    • 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 1.054 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

    $35.58changed to$33.58

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.77 changed to 0.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $34.16changed to$35.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.72 changed to 0.77
    • 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

    $33.25changed to$34.16

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.71 changed to 0.72
    • 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

    $34.08changed to$33.25

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.73 changed to 0.71

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $30.07changed to$34.08

    • 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
    • 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

    $30.01changed to$30.07

    • Conversion factor 35.8043 changed to 35.8887
    • 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

    $30.12changed to$30.01

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $29.97changed to$30.12

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $29.49changed to$29.97

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.64 changed to 0.65
    • 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

    $29.94changed to$29.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.69 changed to 0.64
    • 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: $29.94

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$30.50Not available in this settingRVU26D
2026-07-01$30.50Not available in this settingRVU26C
2026-04-01$30.50Not available in this settingRVU26B
2026-01-01$30.50Not available in this settingRVU26A
2025-10-01$27.58Not available in this settingRVU25D
2025-07-01$27.58Not available in this settingRVU25C
2025-04-01$27.58Not available in this settingRVU25B
2025-01-01$27.58Not available in this settingRVU25A
2024-10-01$29.57Not available in this settingRVU24D
2024-07-01$29.57Not available in this settingRVU24C
2024-04-01$29.57Not available in this settingRVU24B
2024-03-09$29.57Not available in this settingRVU24AR
2024-01-01$29.09Not available in this settingRVU24A
2023-10-01$31.06Not available in this settingRVU23D
2023-07-01$31.06Not available in this settingRVU23C
2023-04-01$31.06Not available in this settingRVU23B
2023-01-01$31.06Not available in this settingRVU23A
2022-10-01$33.58Not available in this settingRVU22D
2022-07-01$33.58Not available in this settingRVU22C
2022-04-01$33.58Not available in this settingRVU22B
2022-01-01$33.58Not available in this settingRVU22A
2021-10-01$35.58Not available in this settingRVU21D
2021-07-01$35.58Not available in this settingRVU21C
2021-04-01$35.58Not available in this settingRVU21B
2021-01-01$35.58Not available in this settingRVU21A
2020-10-01$34.16Not available in this settingRVU20D
2020-07-01$34.16Not available in this settingRVU20C
2020-04-01$34.16Not available in this settingRVU20B
2020-01-01$34.16Not available in this settingRVU20A
2019-10-01$33.25Not available in this settingRVU19D
2019-07-01$33.25Not available in this settingRVU19C
2019-04-01$33.25Not available in this settingRVU19B
2019-01-01$33.25Not available in this settingRVU19A
2018-10-01$34.08Not available in this settingRVU18D
2018-07-01$34.08Not available in this settingRVU18C
2018-04-01$34.08Not available in this settingRVU18B
2018-01-01$34.08Not available in this settingRVU18AR1
2017-10-01$30.07Not available in this settingRVU17D
2017-07-01$30.07Not available in this settingRVU17C
2017-04-01$30.07Not available in this settingRVU17B
2017-01-01$30.07Not available in this settingRVU17A
2016-10-01$30.01Not available in this settingRVU16D
2016-07-01$30.01Not available in this settingRVU16C
2016-04-01$30.01Not available in this settingRVU16B
2016-01-01$30.01Not available in this settingRVU16A
2015-10-01$30.12Not available in this settingRVU15D
2015-07-01$30.12Not available in this settingRVU15C
2015-04-01$29.97Not available in this settingRVU15B
2015-01-01$29.97Not available in this settingRVU15A
2014-10-01$29.49Not available in this settingRVU14D
2014-07-01$29.49Not available in this settingRVU14C
2014-04-01$29.49Not available in this settingRVU14B
2014-01-01$29.49Not available in this settingRVU14A
2013-10-01$29.94Not available in this settingRVU13D
2013-07-01$29.94Not available in this settingRVU13C
2013-04-01$29.94Not available in this settingRVU13B
2013-01-01$29.94Not available in this settingRVU13AR

Price 96523 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

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
RVUs for 96523PPRRVU2026_Oct_nonQPP.csv, line 12,814 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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