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See a sample rate comparisonCPT 96523 Fee Schedule
Last Verified: September 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.
Clean Drug Access Port, A Procedure To Wash Out An Access Port Implanted Into A Vein. The Port Is Used To Inject Drugs For Therapies. Cleaning Keeps Clots From Plugging The Port.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 96523 |
| Medicaid Fee Schedule | View Medicaid rates for 96523 |
National average reimbursement for CPT 96523 by major payers:
$36.90
$33.62
$35.88
$49.40
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CPT 96523
5 of 25 sample ratesHigher to lower in this preview
Methodist Medical Center Of Illinois
$207.16Published rateOverlook Hospital
Atlantic Health System Inc
$52.54Published rateMelanie Smith
Atlantic Health System Inc
$40.90Published rateRachel Rohr
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$35.15Published rateMiguel Arenas
Miguel A Arenas Md PC
$22.62Published rate
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See a sample payer proposalCPT 96523 vs. Other Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Codes
The CPT 96523 code is part of the Medicine Services and Procedures services used for Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration. 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 96523 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 |
|---|---|---|
| 96423-CPT | Low | Chemo Ia Infuse Each Addl Hr, Chemotherapy Administration Intra Arterial Infusion Technique Each Additional Hour List Separately In Addition To Code For Primary Procedure |
| 96425-CPT | Moderate | Chemotherapy Infusion Method, Chemotherapy Administration Intra Arterial Infusion Technique Initiation Of Prolonged Infusion More Than 8 Hours Requiring The Use Of A Portable Or Implantable Pump |
| 96446-CPT | Moderate | Drug Instilled Into Body Space, A Chemotherapy Agent Or Other Complex Drug Is Given By Instilling One Or More Drugs Into A Body Cavity Or Space. The Drug May Be Injected Though A Thin Tube (Catheter) That Has Been Implanted Previously. |
| 96523-CPT | Low | Clean Drug Access Port, A Procedure To Wash Out An Access Port Implanted Into A Vein. The Port Is Used To Inject Drugs For Therapies. Cleaning Keeps Clots From Plugging The Port. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96523. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96523 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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