Remove/insert drug implant

CPT code 11983 covers the removal and reinsertion of a contraceptive drug implant, typically used when replacing an expired implant with a new one during the same visit.

Showing rates for

National Average

Base Medicare rate

$137.47

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.91

PE RVU (NF)

MP RVU

0.34

Total RVU

4.25

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify whether service is performed in facility or non-facility setting and bill accordingly
Impact: $37.20 difference in Medicare reimbursement between non-facility ($137.47) and facility ($100.27) rates
Do not use 11983 if only removing or only inserting an implant; use 11982 for insertion only or 11976 for removal only
Impact: Incorrect code selection can result in underpayment of $20-60 or denials requiring resubmission
Document medical necessity for same-day removal and reinsertion, especially if implant has not reached expiration
Impact: Prevents medical necessity denials that delay payment by 30-90 days
Bill for the implant device separately using appropriate HCPCS J-code (J7307 for Nexplanon) with modifier JB
Impact: Device reimbursement of approximately $800-950 in addition to procedure fee
When billing with modifier 25 for E/M service, ensure documentation clearly shows separately identifiable service beyond procedure decision-making
Impact: Successful modifier 25 billing adds $75-200 for preventive or problem-focused visit
Check patient's contraceptive coverage under ACA preventive services; many commercial payers cover at 100% with no cost-sharing
Impact: Ensures patient satisfaction and reduces accounts receivable issues; may affect facility vs. non-facility choice

Common denials

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Frequently asked questions

What is the difference between CPT 11983 and 11982?

CPT 11983 is used when both removing an old implant and inserting a new implant during the same visit, while CPT 11982 covers insertion of a new implant only without removal. Using 11983 for replacement pays $137.47 (non-facility) versus $119.08 for 11982 insertion alone, reflecting the additional work of removal.

How much does Medicare pay for CPT code 11983 in 2025?

Medicare pays $137.47 for CPT 11983 in non-facility settings and $100.27 in facility settings based on 2025 national average rates. Actual payment may vary by geographic locality based on the Medicare Geographic Practice Cost Index (GPCI) adjustments.

Can I bill an E/M code with CPT 11983 on the same day?

Yes, you can bill an E/M code with CPT 11983 using modifier 25 if there is a significant, separately identifiable evaluation and management service beyond the decision to replace the implant, such as an annual wellness visit or evaluation of unrelated conditions. Documentation must clearly distinguish the separate services.

Is the contraceptive implant device included in CPT 11983?

No, the device is billed separately using HCPCS code J7307 (etonogestrel implant, Nexplanon) or the appropriate code for the specific device used. CPT 11983 covers only the physician service of removing and inserting the implant, not the implant supply itself.

What RVU value does CPT 11983 have?

CPT 11983 has a total RVU of 4.25 for 2025, consisting of 1.91 work RVU, 2.00 practice expense RVU (non-facility), 0.85 practice expense RVU (facility), and 0.34 malpractice RVU. These values are multiplied by the conversion factor of 32.3465 to determine payment.

When should I use CPT 11976 instead of 11983?

Use CPT 11976 when only removing a contraceptive implant without inserting a new one, such as when a patient wants the implant removed but does not want replacement or is switching to a different contraceptive method. If you remove and insert during the same encounter, 11983 is correct.

Does CPT 11983 have a global period?

CPT 11983 has a 10-day global period, meaning routine follow-up care for 10 days after the procedure is included in the payment. Separately billable services during this period require appropriate modifiers (24 for unrelated E/M, 25 for significant separately identifiable E/M) and clear documentation.