Rmvl i-artic rx delivery dev

CPT code 20705 covers the removal of a drug delivery device that was previously placed inside a joint to provide sustained medication release. This is a surgical procedure to extract the implanted device when treatment is complete or complications arise.

Showing rates for

National Average

Base Medicare rate

$120.33

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

2.15

PE RVU (NF)

1.13

MP RVU

0.44

Total RVU

3.72

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

NCCI bundling edits

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Billing tips

Always verify the original device insertion CPT code and confirm the drug delivery device qualifies as intra-articular (not soft tissue or other anatomical location)
Impact: Prevents denials for incorrect code selection; soft tissue device removal requires different codes (10120-10121) with different reimbursement rates
Document the specific joint accessed, approach used, device type/manufacturer, reason for removal, and any complications encountered during extraction
Impact: Critical for medical necessity support and appeals; inadequate documentation causes 40-60% of initial denials for this code
Bill 20705 separately from arthroscopy codes only when performed through a separate open incision; arthroscopic device removal should use arthroscopy codes with foreign body removal
Impact: Prevents unbundling denials that result in 100% claim rejection and potential audit flags
Append modifier 22 with detailed operative note when removal time exceeds 45 minutes or significant scar tissue/adhesions require extensive dissection
Impact: Can increase reimbursement by $24-60 above the base $120.33 rate; requires comparative documentation showing typical vs actual work
For Medicare patients, verify the device removal meets medical necessity criteria (device failure, infection, completed therapy) and obtain ABN if questionable coverage
Impact: Protects practice from $120.33 write-off if Medicare denies as not medically necessary; allows patient billing option
When billing bilaterally, confirm payer accepts modifier 50 versus LT/RT on separate lines; Medicare requires modifier 50 for bilateral procedures

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT 20705?

The 2025 Medicare national average reimbursement for CPT 20705 is $120.33 for both facility and non-facility settings. This is based on 3.72 total RVUs (2.15 work RVU, 1.13 PE RVU, 0.44 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 20705 be billed with an arthroscopy code on the same date?

CPT 20705 should generally not be billed separately with arthroscopy codes unless the device removal was performed through a distinct open incision separate from the arthroscopic portals. If device removal is performed arthroscopically, use the appropriate arthroscopy code with foreign body removal rather than 20705. When legitimately billing both, append modifier 59 to indicate a distinct procedural service.

What documentation is required to support medical necessity for CPT 20705?

Documentation must include the clinical indication for device removal such as completion of therapy protocol, device malfunction or migration, infection with supporting lab/imaging findings, persistent pain or adverse reaction, or patient-specific contraindication to continued therapy. Pre-operative notes should show conservative management attempts or explain why immediate removal is necessary.

How do I bill CPT 20705 for bilateral device removal?

For bilateral device removal performed during the same operative session, append modifier 50 to CPT 20705. Medicare and most payers will reimburse at 150% of the single procedure rate ($180.50 total). Some payers may require billing on two separate lines with LT and RT modifiers instead of modifier 50, so verify payer-specific requirements.

What is the difference between CPT 20705 and foreign body removal codes?

CPT 20705 is specific to removal of intra-articular drug delivery devices (implanted therapeutic devices) from within a joint space. Foreign body removal codes (10120-10121, 27086-27087) are used for non-therapeutic objects, traumatic foreign material, or soft tissue implants. The key distinction is that 20705 applies only to previously placed therapeutic drug delivery systems within joints.

Can CPT 20705 be billed during the global period of the device insertion?

If device removal is required during the global period due to a complication (infection, device failure, adverse reaction), append modifier 78 for a return to the operating room. If removal is for an unrelated condition, use modifier 79. Elective removal as part of the planned treatment protocol during the global period is generally considered part of the original procedure and not separately billable.

What modifiers are most commonly used with CPT 20705?

The most common modifiers are LT/RT for laterality specification (required for joint procedures), modifier 50 for bilateral procedures, modifier 59 when billed with other procedures to indicate distinct service, modifier 22 for increased procedural complexity, and modifier 51 when performed as a secondary procedure. Laterality modifiers are mandatory for proper claim processing.