Billing code 11983: Drug implantMedicare rate & RVUs in Washington
Reports removal of an existing nonbiodegradable subcutaneous drug implant and placement of a replacement implant during the same encounter.
Medicare pays $146.49–$161.80 for 11983 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 11983 covers
Code 11983 describes removing a nonbiodegradable drug-delivery implant from beneath the skin and placing a replacement during the same encounter. A common example is removal and replacement of an etonogestrel contraceptive implant in the upper arm. A qualified clinician, such as a physician or other authorized practitioner, performs the procedure in an office or facility, typically using local anesthesia and a small incision to remove the existing device and insert the new one.
Report 11983 when both removal and replacement are performed; the record should identify the implant, document both steps, and support the need for the procedure. Do not separately report 11981 and 11982 for those same insertion and removal services. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
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.
Where 11983 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $146.49 | $87.75 |
| Seattle (King Cnty) | $161.80 | $93.36 |
How the 11983 rate is calculated
Each of 11983’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 · 11983
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.86Practice expense 2.13Malpractice 0.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 11983
The CMS indicators that decide how 11983 is paid alongside other services.
CMS payment indicators · 11983
Drug implant
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
11983 without 51 · national office
$144.63
Drug implant
11983-51 · Second procedure: 50%
$72.32
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
11983 compared with similar codes
Compare codes
11983 vs 11981 vs 11982 vs 11976: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 11981Drug implant insertion
- 11981 describes insertion alone. Choose 11983 when the encounter also includes removal of the existing drug implant.
- 11982Implant removal
- 11982 describes removal alone. Choose 11983 when a replacement drug implant is inserted during the same encounter.
- 11976Remove contraceptive capsule
- 11976 addresses removal of a contraceptive capsule. Select the code that matches the device and procedure performed rather than treating it as interchangeable with drug-implant replacement.
11983 billing questions
When should 11983 be reported instead of 11981 or 11982?
Use 11983 when the clinician removes an existing nonbiodegradable drug implant and inserts a replacement during the same encounter. Report 11981 for insertion alone and 11982 for removal alone.
Can 11981 and 11982 also be reported for the same replacement?
Do not separately report those codes for the insertion and removal already represented by 11983.
What documentation supports 11983?
Document the implant removed, the removal and replacement performed, and the clinical reason for the procedure. Identify the new implant and its placement site in the procedure record.
Is modifier 50 appropriate for implants placed on both sides?
No. Modifier 50 is inappropriate for this service based on its descriptor and anatomy.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
When is assistant-at-surgery payment allowed?
Payment for an assistant at surgery requires documentation of medical necessity. 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 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
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