Rmvl imed rx delivery device

CPT code 20703 is used when a surgeon removes a small implanted device that was previously placed under the skin to slowly release medication over time. This is a separate procedure from removing larger pumps or reservoirs.

Showing rates for

National Average

Base Medicare rate

$101.57

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

1.8

PE RVU (NF)

0.96

MP RVU

0.38

Total RVU

3.14

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

NCCI bundling edits

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Billing tips

Verify the device complexity level before coding - simple foreign body removal uses 10120/10121, while programmable pump removal uses 62365
Impact: Prevents $50-500 undercoding or overcoding errors; 20703 at $101.57 falls between simple removal codes (~$75) and complex pump codes (~$600)
Document specific device type, manufacturer, and reason for removal (migration, infection, patient request, malfunction) to support medical necessity
Impact: Reduces denial rate by approximately 40% and supports appeals when medical necessity is questioned
Bill same-day E/M services with modifier 25 only when significant separately identifiable evaluation beyond the decision for removal is documented
Impact: Can add $75-200 in reimbursement but triggers audit risk if not properly documented as separate service
For bilateral or multiple device removals, append modifier 50 or bill with modifier 59/XS on second line rather than using units, as unit billing often causes auto-denials
Impact: Proper modifier use can secure additional 50-100% payment ($50.79-101.57) for second device versus denial
Check LCD/NCD policies for your MAC regarding removal timeframe - some payers scrutinize removals within 30 days of implantation as potentially bundled services
Impact: Early identification of bundling rules prevents denials and can support modifier 78 use for reduced but appropriate payment
Query the surgeon about unusual difficulty, extensive dissection, or complications during removal to determine if unlisted code or additional documentation is warranted
In cases of significant additional work, narrative reports can support higher reimbursement or prevent downcoding audits

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 20703 in 2025?

The 2025 Medicare national average reimbursement for CPT 20703 is $101.57 for both facility and non-facility settings. This rate is based on 3.14 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary based on geographic locality adjustments.

What is the difference between CPT 20703 and simple foreign body removal codes?

CPT 20703 is specifically for removing implanted drug delivery devices of intermediate complexity, requiring surgical dissection and technique. Simple foreign body removal (10120/10121) is for superficial objects not intentionally implanted for therapeutic purposes. The key distinction is the device's therapeutic purpose and the complexity of removal required.

Can CPT 20703 be billed for contraceptive implant removal?

CPT 20703 may be appropriate for complicated contraceptive implant removals requiring significant dissection due to migration, deep location, or fragmentation. Standard, uncomplicated contraceptive implant removal is typically coded with device-specific codes (11976 for Nexplanon/Implanon). Documentation must support the increased complexity to justify 20703.

What modifiers are most commonly used with CPT 20703?

Common modifiers for 20703 include modifier 59 (distinct procedural service when billed with other procedures), modifier 78 (return to OR for complication during global period), modifier 79 (unrelated procedure during global period), and LT/RT for laterality. Modifier 50 may apply for true bilateral device removals.

How many RVUs is CPT code 20703 worth in 2025?

CPT 20703 has 3.14 total RVUs in 2025, consisting of 1.8 work RVUs, 0.96 practice expense RVUs (both facility and non-facility), and 0.38 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule released December 23, 2024.

What documentation is required to bill CPT 20703 without denial?

Required documentation includes the specific device type and manufacturer, original implantation date, clear medical necessity for removal, anatomic location, surgical approach with dissection details, device condition upon extraction, and any complications. The operative note must demonstrate intermediate complexity beyond simple extraction to support code selection.

Can CPT 20703 be billed with an E/M service on the same day?

Yes, an E/M service can be billed with CPT 20703 on the same day using modifier 25, but only when significant, separately identifiable evaluation and management beyond the decision for device removal is performed and documented. The E/M must address issues distinct from the standard pre-procedure assessment.