$131.37–$151.16
Choose 96522 for an implanted systemic-delivery pump or reservoir. Choose 96521 when the medication is delivered by a portable pump.
On this page
CMS RVU26D · Effective 2026-10-01
96522 Pump refill Medicare reimbursement rates in Texas
Reports refilling and maintaining an implanted pump or reservoir that delivers medication through a systemic route such as intravenous or intra-arterial access. Compare 96522 office and facility rates across CMS payment localities in Texas.
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 96522 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$114.66–$131.72
8 of 8 localities have a supported rate.
Facility setting
No 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.
Where 96522 pays more and less in Texas
8 payment localities
$114.66 to $131.72
Drug delivery
About 96522: Implantable systemic drug pump refill
Reports refilling and maintaining an implanted pump or reservoir that delivers medication through a systemic route such as intravenous or intra-arterial access.
This service covers accessing an implanted drug-delivery pump or reservoir, replenishing its medication supply, and performing the associated maintenance. It is used for implanted systems delivering medication through routes such as intravenous or intra-arterial access; an oncology example is a hepatic artery infusion pump. A physician or clinical staff member may perform the work in an office setting, with billing subject to the physician-supervision requirement described below.
Choose this code for an implanted system delivering medication systemically, rather than a portable pump or a pump delivering medication into the spinal or brain spaces. Document the implanted device and delivery route, the refill and maintenance performed, the medication and amount placed in the reservoir, and relevant pump checks. Under the CMS rule, this is an incident-to service and may be billed only when performed under physician supervision.
CMS billing rules for 96522
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.21 · 6%
- Practice expense (office) RVU3.47 · 93%
- Malpractice RVU0.07 · 2%
1.9K
Medicare services in 2024 · #2486 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.
96522 compared with similar codes
Office rates for Texas, from the same CMS release.
96523
No office rateIrrig drug delivery device
Code 96523 is for irrigation of an implanted venous access device. It does not describe replenishing an implanted medication pump reservoir.
$90.45–$101.22
Use 62369 for refill and maintenance of an implanted pump delivering medication into spinal or brain spaces when reprogramming is not performed; 96522 is for systemic delivery.
$91.15–$100.73
Use 62370 for spinal or brain infusion-pump refill and maintenance when reprogramming is performed. Code 96522 describes an implanted pump for systemic drug delivery.
Compare 96522 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $131.72 | Facility Unavailable |
| Beaumont | Office $114.66 | Facility Unavailable |
| Brazoria | Office $123.75 | Facility Unavailable |
| Dallas | Office $124.52 | Facility Unavailable |
| Fort Worth | Office $123.39 | Facility Unavailable |
| Galveston | Office $124.10 | Facility Unavailable |
| Houston | Office $125.38 | Facility Unavailable |
| Rest Of Texas | Office $119.12 | Facility Unavailable |
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96522 billing questions
How does this differ from 96521?
Use 96522 for an implanted pump or reservoir delivering medication systemically. Code 96521 describes refill and maintenance of a portable pump.
Can 96522 be used for an intrathecal pump refill?
No. For an implanted pump delivering medication into spinal or brain spaces, use the applicable spinal or brain infusion-pump refill code, such as 62369 or 62370.
What documentation supports 96522?
Record the implanted pump type and delivery route, the refill and maintenance performed, the medication and amount placed, and relevant pump checks.
Who may perform the service for Medicare billing?
The CMS rule identifies this as an incident-to service: it may be billed only when performed under physician supervision.
Is flushing an implanted venous access device the same service?
No. Irrigation of an implanted venous access device is distinct from refilling and maintaining an implanted pump; 96523 describes the irrigation service.
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.
12,81096446,,Chemotx admn pertl cav impl,A,,0.37,4.21,,0.08,,0.12,4.70,0.57,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81196450,,Chemotherapy into cns,A,,1.53,3.15,,0.32,,0.14,4.82,1.99,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81296521,,Refill/maint portable pump,A,,0.21,4.02,,4.02,NA,0.07,4.30,4.30,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81396522,,Refill/maint pump/resvr syst,A,,0.21,3.47,,3.47,NA,0.07,3.75,3.75,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81496523,,Irrig drug delivery device,T,,0.04,0.73,,0.73,NA,0.01,0.78,0.78,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81596542,,Chemotherapy injection,A,,0.75,3.21,,0.26,,0.06,4.02,1.07,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,81696547,,Intraop hipec px 1st 60 min,A,,6.53,1.82,NA,1.82,,1.52,9.87,9.87,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00