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CMS RVU26D · Effective 2026-10-01

11981 in Redding

Office / nonfacility

$111.02

Base rate per service

Facility setting

$53.18

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Implant procedure

About 11981: Non-biodegradable drug implant insertion

Report 11981 for inserting a non-biodegradable drug delivery implant, such as a subdermal contraceptive implant placed in the upper arm.

Code 11981 describes the procedure to place a non-biodegradable implant that releases medication over time. A common example is insertion of an etonogestrel contraceptive implant beneath the skin of the upper arm. The service is typically performed in an office or other outpatient setting by a physician or other qualified clinician. The implant product is distinct from the insertion procedure; for an etonogestrel contraceptive implant, the product may be reported with HCPCS code J7307 when applicable.

Report the insertion when the implant is placed, and document the medication or implant, insertion site, and completed procedure. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 11981

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.11 · 34%
  • Practice expense (office) RVU1.90 · 59%
  • Malpractice RVU0.21 · 7%

8.6K

Medicare services in 2024 · #1554 by national volume

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.

11981 compared with similar codes

Office rates for Redding, from the same CMS release.

11980

Hormone pellets

Subcutaneous implantation

$100.17

Use 11980 for insertion of hormone pellets. Use 11981 for a non-biodegradable drug delivery implant, such as an etonogestrel contraceptive implant.

11982

Implant removal

Removal only

$117.80

11982 reports removal of a drug implant device. It does not describe placing an implant.

11983

Drug implant

Removal with replacement

$147.24

11983 describes removal of an existing drug implant followed by insertion of a replacement. Use 11981 when the service is insertion without that removal-and-reinsertion sequence.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 11981 is $111.61—$0.59 higher than the $111.02 rate in Redding. Both use the same code, release and participation basis.

11981 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $111.02

  2. Bakersfield

    $111.61

    $0.59 higher than Redding

  3. Chico

    $111.02

    The same base rate than Redding

  4. El Centro

    $111.05

    $0.03 higher than Redding

  5. Fresno

    $111.02

    The same base rate than Redding

  6. Hanford-Corcoran

    $111.02

    The same base rate than Redding

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $118.33

    $7.31 higher than Redding

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 11981 ranges from $95.20 in Arkansas to $136.42 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Merced

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Modesto

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Napa

    California · 11981

    Office

    $126.62

    Facility

    $57.06

    $15.60 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 11981

    Office

    $117.49

    Facility

    $55.12

    $6.47 higher than Redding for the office setting.

  • Rest Of California

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 11981

    Office

    $113.28

    Facility

    $55.44

    $2.26 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 11981

    Office

    $115.98

    Facility

    $54.60

    $4.96 higher than Redding for the office setting.

  • Salinas

    California · 11981

    Office

    $115.54

    Facility

    $54.37

    $4.52 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 11981

    Office

    $117.89

    Facility

    $54.77

    $6.87 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 11981

    Office

    $133.30

    Facility

    $58.89

    $22.28 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 11981

    Office

    $133.06

    Facility

    $58.65

    $22.04 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 11981

    Office

    $136.42

    Facility

    $60.33

    $25.40 higher than Redding for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 11981

    Office

    $135.45

    Facility

    $59.35

    $24.43 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 11981

    Office

    $113.75

    Facility

    $53.64

    $2.73 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 11981

    Office

    $118.72

    Facility

    $54.60

    $7.70 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 11981

    Office

    $115.87

    Facility

    $54.34

    $4.85 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 11981

    Office

    $119.88

    Facility

    $55.07

    $8.86 higher than Redding for the office setting.

  • Stockton

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 11981

    Office

    $126.27

    Facility

    $56.72

    $15.25 higher than Redding for the office setting.

  • Visalia

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 11981

    Office

    $111.02

    Facility

    $53.18

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 11981

    Office

    $121.64

    Facility

    $59.47

    $10.62 higher than Redding for the office setting.

  • Miami

    Florida · 11981

    Office

    $120.88

    Facility

    $65.94

    $9.86 higher than Redding for the office setting.

  • Chicago

    Illinois · 11981

    Office

    $117.21

    Facility

    $64.17

    $6.19 higher than Redding for the office setting.

  • Manhattan

    New York · 11981

    Office

    $124.31

    Facility

    $62.99

    $13.29 higher than Redding for the office setting.

  • Alaska*

    Alaska · 11981

    Office

    $127.06

    Facility

    $70.86

    $16.04 higher than Redding for the office setting.

  • Alabama

    Alabama · 11981

    Office

    $96.57

    Facility

    $50.40

    $14.45 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 11981

    Office

    $95.20

    Facility

    $49.87

    $15.82 lower than Redding for the office setting.

  • Arizona

    Arizona · 11981

    Office

    $104.57

    Facility

    $53.44

    $6.45 lower than Redding for the office setting.

  • Colorado

    Colorado · 11981

    Office

    $110.52

    Facility

    $54.37

    $0.50 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 11981

    Office

    $114.65

    Facility

    $57.81

    $3.63 higher than Redding for the office setting.

  • Delaware

    Delaware · 11981

    Office

    $106.27

    Facility

    $54.13

    $4.75 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 11981

    Office

    $114.04

    Facility

    $60.58

    $3.02 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 11981

    Office

    $108.29

    Facility

    $57.84

    $2.73 lower than Redding for the office setting.

  • Atlanta

    Georgia · 11981

    Office

    $110.09

    Facility

    $56.47

    $0.93 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 11981

    Office

    $102.04

    Facility

    $54.97

    $8.98 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 11981

    Office

    $113.29

    Facility

    $53.29

    $2.27 higher than Redding for the office setting.

  • Iowa

    Iowa · 11981

    Office

    $97.93

    Facility

    $49.64

    $13.09 lower than Redding for the office setting.

  • Idaho

    Idaho · 11981

    Office

    $98.78

    Facility

    $50.23

    $12.24 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 11981

    Office

    $109.59

    Facility

    $61.03

    $1.43 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 11981

    Office

    $105.98

    Facility

    $57.80

    $5.04 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 11981

    Office

    $114.94

    Facility

    $60.74

    $3.92 higher than Redding for the office setting.

  • Indiana

    Indiana · 11981

    Office

    $99.31

    Facility

    $50.39

    $11.71 lower than Redding for the office setting.

  • Kansas

    Kansas · 11981

    Office

    $97.98

    Facility

    $50.27

    $13.04 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 11981

    Office

    $99.91

    Facility

    $52.99

    $11.11 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 11981

    Office

    $104.76

    Facility

    $55.10

    $6.26 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 11981

    Office

    $99.96

    Facility

    $53.25

    $11.06 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 11981

    Office

    $120.61

    Facility

    $57.60

    $9.59 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 11981

    Office

    $110.08

    Facility

    $54.51

    $0.94 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 11981

    Office

    $114.44

    Facility

    $57.81

    $3.42 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 11981

    Office

    $108.11

    Facility

    $54.70

    $2.91 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 11981

    Office

    $99.82

    Facility

    $51.27

    $11.20 lower than Redding for the office setting.

  • Southern Maine

    Maine · 11981

    Office

    $104.39

    Facility

    $52.09

    $6.63 lower than Redding for the office setting.

  • Detroit

    Michigan · 11981

    Office

    $110.14

    Facility

    $59.22

    $0.88 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 11981

    Office

    $102.93

    Facility

    $54.75

    $8.09 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 11981

    Office

    $104.45

    Facility

    $50.15

    $6.57 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 11981

    Office

    $103.52

    Facility

    $53.96

    $7.50 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 11981

    Office

    $104.52

    Facility

    $54.28

    $6.50 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 11981

    Office

    $98.61

    Facility

    $53.12

    $12.41 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 11981

    Office

    $96.90

    Facility

    $51.46

    $14.12 lower than Redding for the office setting.

  • Montana**

    Montana · 11981

    Office

    $107.54

    Facility

    $54.76

    $3.48 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 11981

    Office

    $100.77

    Facility

    $51.53

    $10.25 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 11981

    Office

    $103.38

    Facility

    $50.61

    $7.64 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 11981

    Office

    $98.30

    Facility

    $49.59

    $12.72 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 11981

    Office

    $109.28

    Facility

    $54.34

    $1.74 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 11981

    Office

    $120.52

    Facility

    $59.30

    $9.50 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 11981

    Office

    $115.55

    Facility

    $57.92

    $4.53 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 11981

    Office

    $103.69

    Facility

    $55.30

    $7.33 lower than Redding for the office setting.

  • Nevada**

    Nevada · 11981

    Office

    $106.44

    Facility

    $53.62

    $4.58 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 11981

    Office

    $127.93

    Facility

    $65.18

    $16.91 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 11981

    Office

    $116.72

    Facility

    $58.93

    $5.70 higher than Redding for the office setting.

  • Queens

    New York · 11981

    Office

    $124.57

    Facility

    $62.20

    $13.55 higher than Redding for the office setting.

  • Rest Of New York

    New York · 11981

    Office

    $102.29

    Facility

    $52.16

    $8.73 lower than Redding for the office setting.

  • Ohio

    Ohio · 11981

    Office

    $102.09

    Facility

    $53.90

    $8.93 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 11981

    Office

    $99.20

    Facility

    $52.07

    $11.82 lower than Redding for the office setting.

  • Portland

    Oregon · 11981

    Office

    $113.39

    Facility

    $54.76

    $2.37 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 11981

    Office

    $105.21

    Facility

    $52.65

    $5.81 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 11981

    Office

    $112.17

    Facility

    $57.24

    $1.15 higher than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 11981

    Office

    $101.96

    Facility

    $53.52

    $9.06 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 11981

    Office

    $108.14

    Facility

    $54.79

    $2.88 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 11981

    Office

    $109.59

    Facility

    $55.08

    $1.43 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 11981

    Office

    $101.68

    Facility

    $52.91

    $9.34 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 11981

    Office

    $102.89

    Facility

    $50.12

    $8.13 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 11981

    Office

    $98.53

    Facility

    $50.56

    $12.49 lower than Redding for the office setting.

  • Austin

    Texas · 11981

    Office

    $110.51

    Facility

    $54.67

    $0.51 lower than Redding for the office setting.

  • Beaumont

    Texas · 11981

    Office

    $101.34

    Facility

    $53.32

    $9.68 lower than Redding for the office setting.

  • Brazoria

    Texas · 11981

    Office

    $105.73

    Facility

    $53.43

    $5.29 lower than Redding for the office setting.

  • Dallas

    Texas · 11981

    Office

    $106.63

    Facility

    $54.07

    $4.39 lower than Redding for the office setting.

  • Fort Worth

    Texas · 11981

    Office

    $106.09

    Facility

    $54.06

    $4.93 lower than Redding for the office setting.

  • Galveston

    Texas · 11981

    Office

    $106.20

    Facility

    $53.79

    $4.82 lower than Redding for the office setting.

  • Houston

    Texas · 11981

    Office

    $110.04

    Facility

    $57.64

    $0.98 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 11981

    Office

    $103.63

    Facility

    $53.55

    $7.39 lower than Redding for the office setting.

  • Utah

    Utah · 11981

    Office

    $103.03

    Facility

    $53.42

    $7.99 lower than Redding for the office setting.

  • Virginia

    Virginia · 11981

    Office

    $104.41

    Facility

    $52.53

    $6.61 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 11981

    Office

    $108.14

    Facility

    $54.79

    $2.88 lower than Redding for the office setting.

  • Vermont

    Vermont · 11981

    Office

    $103.45

    Facility

    $51.21

    $7.57 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 11981

    Office

    $109.72

    Facility

    $54.15

    $1.30 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 11981

    Office

    $122.53

    Facility

    $57.77

    $11.51 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 11981

    Office

    $100.03

    Facility

    $49.47

    $10.99 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 11981

    Office

    $102.26

    Facility

    $56.40

    $8.76 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 11981

    Office

    $105.73

    Facility

    $52.95

    $5.29 lower than Redding for the office setting.

See how rates vary across the country

11981 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$95.20

$127.06

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$127.061
AL$96.571
AR$95.201
AZ$104.571
CA$111.02–$136.4229
CO$110.521
CT$114.651
DC$121.641
DE$106.271
FL$108.29–$120.883
GA$102.04–$110.092
GU$113.291
HI$113.291
IA$97.931
ID$98.781
IL$105.98–$117.214
IN$99.311
KS$97.981
KY$99.911
LA$99.96–$104.762
MA$110.08–$120.612
MD$108.11–$121.643
ME$99.82–$104.392
MI$102.93–$110.142
MN$104.451
MO$98.61–$104.523
MS$96.901
MT$107.541
NC$100.771
ND$103.381
NE$98.301
NH$109.281
NJ$115.55–$120.522
NM$103.691
NV$106.441
NY$102.29–$127.935
OH$102.091
OK$99.201
OR$105.21–$113.392
PA$101.96–$112.172
PR$108.141
RI$109.591
SC$101.681
SD$102.891
TN$98.531
TX$101.34–$110.518
UT$103.031
VA$104.41–$121.642
VI$108.141
VT$103.451
WA$109.72–$122.532
WI$100.031
WV$102.261
WY$105.731

Explore 11981 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 11981 in Redding, the physician’s office rate is $111.02 and the facility-setting rate is $53.18: a difference of $57.84.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 11981 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$122.12

$111.02 × 110% = $122.12

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 11981 in Redding.

PPRRVU2026_Oct_nonQPP.csv

1,393

Code
11981
Physician work
1.11
Practice expense
1.90
Malpractice
0.21

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 11981 in Redding
ComponentRVULocality factorAdjusted
Physician work1.11× 1.0171.1289
Practice expense1.90× 1.0962.0824
Malpractice0.21× 0.5360.1126
Total RVUs3.3238
Conversion factor× 33.4009

Office / nonfacility rate, Redding$111.02

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 11981 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.111.017
Practice expense1.91.096
Malpractice0.210.536

(1.11 × 1.017 + 1.9 × 1.096 + 0.21 × 0.536) × $33.4009 = $111.02

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.111.017
Practice expense0.321.096
Malpractice0.210.536

(1.11 × 1.017 + 0.32 × 1.096 + 0.21 × 0.536) × $33.4009 = $53.18

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

11981 · Office / nonfacility

$111.02

Effective 2026-10-01

The base rate is $10.43 higher than on 2025-10-01, moving from $100.59 to $111.02 (10.4%).

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

    $100.59changed to$111.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.14 changed to 1.11
    • Practice expense RVU 1.68 changed to 1.90
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $100.59

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$111.02$53.18RVU26D
2026-07-01$111.02$53.18RVU26C
2026-04-01$111.02$53.18RVU26B
2026-01-01$111.02$53.18RVU26A
2025-10-01$100.59$60.29RVU25D
2025-07-01$100.59$60.29RVU25C
2025-04-01$100.59$60.29RVU25B
2025-01-01$100.59$60.29RVU25A

11981 billing questions

How does 11981 differ from 11980?

11981 is for inserting a non-biodegradable drug delivery implant, such as an etonogestrel contraceptive implant. 11980 describes insertion of hormone pellets.

Should the implant product be reported separately?

The insertion procedure and the drug implant product are distinct. For an etonogestrel contraceptive implant, HCPCS J7307 may report the product when applicable.

Is modifier 50 appropriate for two implants?

No. CMS identifies modifier 50 as inappropriate for 11981. Report the insertion service based on the procedure performed rather than billing it as a bilateral service.

What documentation supports 11981?

Document the implant or medication used, the insertion site, and that the implant was placed. For an upper-arm contraceptive implant, the record should support the completed insertion.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 11981PPRRVU2026_Oct_nonQPP.csv, line 1,393 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet