CPT 11981 is a medical code used by healthcare providers to document and receive reimbursement for the insertion of a drug delivery implant (e.g., bioresorbable, biodegradable, non-biodegradable). It falls under surgical procedures on the integumentary system.

What factors affect CPT 11981 fee schedules?

Factors affecting fee schedules for CPT 11981 include government-set Medicare & Medicaid rates, negotiated private insurance rates, geographic location (costs higher in urban areas), and provider type (hospital vs. private practice).

What is the national average reimbursement for CPT 11981?

The national average reimbursement for CPT 11981 varies by major payers, with preview rates like $135.62, $152.63, $156.40, and $186.94 for payers like United, Cigna, Aetna, and BCBS/Anthem respectively.

How can I view detailed CPT 11981 rates?

You can view detailed provider-level rates for CPT 11981 by signing up for a trial with PayerPrice to unlock complete access to provider rates and fee schedules.

CPT stands for Current Procedural Terminology. These are a standardized set of five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to payers for reimbursement. They are essential for accurate medical billing and record-keeping.

How can I find the cost of a medical procedure?

To find the specific cost of a medical procedure based on CPT codes and your location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with CPT codes and specific geographic locations to get relevant pricing information. For the most accurate out-of-pocket estimates, it is also recommended to contact your healthcare provider's billing department and your insurance company directly.

Why are medical costs different between providers?

Medical costs can vary significantly between different providers due to a multitude of factors. These include negotiated rates with various insurance companies, the provider's geographic location, their specialization and reputation, the type of facility (e.g., hospital versus an independent clinic), the technology and equipment utilized, and varying overhead costs. Each provider or healthcare system often has its own unique fee schedule and agreements with different payers.

Payerprice is a service that provides a fee schedule lookup tool designed to help users understand potential medical costs. It allows individuals to search for pricing information for medical procedures using CPT codes and specific geographic locations, assisting them in navigating healthcare expenses.

CPT 11981 Fee Schedule

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Implant Drug Delivery Unit, Procedure To Implant (Insert Under The Skin) A Nonbiodegradable Device That Dispenses A Drug Automatically.

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Integumentary System
Common Place of Service	11 - Office 21 - Inpatient Hospital
Common Modifiers	None AG - Primary physician FP
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 11981
Medicaid Fee Schedule	View Medicaid rates for 11981

National average reimbursement for CPT 11981 by major payers:

$135.62

$152.63

$156.40

$181.82

Compare published rates across providers.

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CPT 11981

5 of 25 sample ratesHigher to lower in this preview

Diana Lo
Sutter Bay Medical Foundation
CAObstetrics & Gynecology PhysicianNPI 1659696508Tax ID 94-1156581
$501.80Published rate
Karen Green
Deaconess Hospital Inc
MIFamily Medicine PhysicianNPI 1659669646Tax ID 35-0593390
$246.78Published rate
Amanda Reeder
Town Center Orthopaedic Associates, P.C.
VAPhysical TherapistNPI 1285363473Tax ID 54-1383504
$145.40Published rate
Elizabeth Watson
Deaconess Hospital Inc
TNCertified Registered Nurse AnesthetistNPI 1942717400Tax ID 35-0593390
$113.38Published rate
Sarah Williams
NYObstetrics & Gynecology PhysicianNPI 1598097883Tax ID 65-1166987
$83.23Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 11981 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 11981 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 11981 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
11976-CPT	Low	Removal Implantable Contracep, Removal Implantable Contraceptive Capsulesremoval Implantable Contraceptive Capsules
11981-CPT	Low	Implant Drug Delivery Unit, Procedure To Implant (Insert Under The Skin) A Nonbiodegradable Device That Dispenses A Drug Automatically.
11982-CPT	Low	Remove Drug Delivery Unit, Procedure To Remove A Nonbiodegradable Device For Dispensing A Drug That Had Been Inserted Under The Skin.
11983-CPT	Moderate	Replace Drug Delivery Unit, Procedure To Remove An Old Drug Delivery Device And Replace It With A New One. The Device Is Nonbiodegradable And Dispenses Doses Automatically.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 11981. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 11981 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 11981 Fee Schedule

Compare published rates across providers.

Diana Lo

Karen Green

Amanda Reeder

Elizabeth Watson

Sarah Williams