$102.06
Use 11980 for insertion of hormone pellets. Use 11981 for a non-biodegradable drug delivery implant, such as an etonogestrel contraceptive implant.
On this page
CMS RVU26D · Effective 2026-10-01
11981 Drug implant insertion Medicare reimbursement rates in Hawaii
Report 11981 for inserting a non-biodegradable drug delivery implant, such as a subdermal contraceptive implant placed in the upper arm. Compare 11981 office and facility rates across CMS payment localities in Hawaii.
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.
What does Medicare pay for 11981 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$113.29
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$53.29
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Hawaii, from the same CMS release.
$119.98
11982 reports removal of a drug implant device. It does not describe placing an implant.
$149.59
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.
Compare 11981 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$113.29
Facility
$53.29
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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 Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,393
- Code
- 11981
- Physician work
- 1.11
- Practice expense
- 1.90
- Malpractice
- 0.21
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.11 | × 1.000 | 1.1100 |
| Practice expense | 1.90 | × 1.137 | 2.1603 |
| Malpractice | 0.21 | × 0.579 | 0.1216 |
| Total RVUs | 3.3919 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$113.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.11 | 1 |
| Practice expense | 1.9 | 1.137 |
| Malpractice | 0.21 | 0.579 |
(1.11 × 1 + 1.9 × 1.137 + 0.21 × 0.579) × $33.4009 = $113.29
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.11 | 1 |
| Practice expense | 0.32 | 1.137 |
| Malpractice | 0.21 | 0.579 |
(1.11 × 1 + 0.32 × 1.137 + 0.21 × 0.579) × $33.4009 = $53.29
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.
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.
1,39011971,,Rmvl tis xpndr wo insj implt,A,,6.84,7.32,NA,7.32,,1.28,15.44,15.44,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39111976,,Remove contraceptive capsule,R,,1.74,2.35,,0.36,,0.30,4.39,2.40,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39211980,,Implant hormone pellet(s),A,,1.07,1.67,,0.23,,0.15,2.89,1.45,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39311981,,Insertion drug dlvr implant,A,,1.11,1.90,,0.32,,0.21,3.22,1.64,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39411982,,Remove drug implant device,A,,1.31,1.89,,0.35,,0.23,3.43,1.89,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39511983,,Remove/insert drug implant,A,,1.86,2.13,,0.46,,0.34,4.33,2.66,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39612001,,Rpr s/n/ax/gen/trnk 2.5cm/<,A,,0.82,2.41,,0.32,,0.18,3.41,1.32,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014