$99.82–$104.39
Choose 11980 for hormone pellets. Code 11981 is for insertion of a drug-delivery implant, such as an implant device used to deliver medication.
On this page
CMS RVU26D · Effective 2026-10-01
11980 Hormone pellets Medicare reimbursement rates in Maine
Report this service when a clinician places hormone pellets beneath the skin, commonly for pellet-based hormone therapy such as testosterone replacement. Compare 11980 office and facility rates across CMS payment localities in Maine.
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 11980 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$90.17–$94.18
2 of 2 localities have a supported rate.
Facility setting
$45.92–$46.51
2 of 2 localities have a supported rate.
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 11980: Subcutaneous hormone pellet implantation
Report this service when a clinician places hormone pellets beneath the skin, commonly for pellet-based hormone therapy such as testosterone replacement.
A clinician places one or more hormone pellets into subcutaneous tissue through a small incision or insertion site. This is commonly performed in an office by clinicians providing hormone therapy, including gynecologists, urologists, endocrinologists, and other qualified providers. The upper buttock or hip region is a typical site. The pellets provide a sustained hormone source after placement; this code represents the implantation procedure, not a skin injection or insertion of a contraceptive capsule.
Report the service for the implantation encounter, documenting the hormone product, number of pellets, insertion site, and procedure performed. The code describes pellet implantation rather than a separate unit for each pellet. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 11980
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.07 · 37%
- Practice expense (office) RVU1.67 · 58%
- Malpractice RVU0.15 · 5%
25.6K
Medicare services in 2024 · #1040 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.
11980 compared with similar codes
Office rates for Maine, from the same CMS release.
$134.64–$139.80
Code 11983 describes removal and reinsertion of a drug implant during the encounter. It is not the code for placing hormone pellets.
11976
No office rateRemove contraceptive capsule
Code 11976 is for removing a contraceptive capsule. It describes removal of that implant, not placement of hormone pellets.
Compare 11980 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$90.17
Facility
$45.92
Southern Maine →
Office / nonfacility
$94.18
Facility
$46.51
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11980 billing questions
How is this different from 11981?
Use 11980 for hormone pellet implantation. Code 11981 describes insertion of a drug-delivery implant and is not the hormone-pellet code.
Should units be reported for each pellet?
The service is the implantation procedure; the code is not reported as one unit per pellet. Document the number of pellets placed.
Does the 0-day global period include same-day follow-up care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can modifier 50 be used for pellets placed on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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.
1,38911970,,Rplcmt tiss xpndr perm implt,A,,7.30,6.84,NA,6.84,,1.35,15.49,15.49,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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