CPT code 62256: Shunt removal, without replacement2026 Medicare rate & RVUs in South Dakota
Reports surgical removal of a complete cerebrospinal fluid shunt system when the system is taken out without replacement.
In South Dakota, Medicare pays $573.87 for 62256 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 62256 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 62256 covers
A neurosurgeon surgically removes the complete CSF diversion system, including its intracranial catheter and connected valve and drainage tubing. A common example is explantation of a ventriculoperitoneal shunt because of infection when the shunt is not replaced during the procedure. The service is generally performed in an operating room; it is distinct from revising one component or adjusting a programmable valve.
Report 62256 when the complete shunt system is removed and no replacement is performed. If a complete system is removed and replaced, compare 62258; if only a catheter or other shunt component is revised, consider the code for that service instead. Documentation should identify the shunt components removed and clarify whether replacement occurred. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Do not append modifier 50 for this service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How South Dakota compares for 62256
Across 109 of 109 payment localities, the facility rate for 62256 runs from $549.40 in Arkansas to $804.45 in Miami, FL. South Dakota pays $573.87. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$573.87
- Los Angeles, CA · California$671.27+$97.40
- Washington, DC area · District of Columbia$717.58+$143.71
- Miami, FL · Florida$804.45+$230.58
- Chicago, IL · Illinois$772.04+$198.17
- Manhattan, NY · New York$762.27+$188.40
- Alaska · Alaska$735.01+$161.14
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $559.27 |
| ArkansasArkansas | — | $549.40 |
| ArizonaArizona | — | $616.33 |
| Bakersfield, CACalifornia | — | $634.41 |
| Chico, CACalifornia | — | $626.66 |
| El Centro, CACalifornia | — | $627.16 |
| Fresno, CACalifornia | — | $626.66 |
| Hanford, CACalifornia | — | $626.66 |
| Madera, CACalifornia | — | $626.66 |
| Merced, CACalifornia | — | $626.66 |
| Modesto, CACalifornia | — | $626.66 |
| Napa, CACalifornia | — | $701.52 |
| Oxnard, CACalifornia | — | $663.76 |
| Redding, CACalifornia | — | $626.66 |
| Rest of CaliforniaCalifornia | — | $626.66 |
| Riverside, CACalifornia | — | $658.45 |
| Sacramento, CACalifornia | — | $651.32 |
| Salinas, CACalifornia | — | $648.92 |
| San Diego, CACalifornia | — | $660.38 |
| Marin County, CACalifornia | — | $731.93 |
| San Francisco, CACalifornia | — | $728.55 |
| San Benito County, CACalifornia | — | $752.80 |
| Santa Clara County, CACalifornia | — | $738.97 |
| San Luis Obispo, CACalifornia | — | $639.56 |
| Santa Cruz, CACalifornia | — | $663.31 |
| Santa Maria, CACalifornia | — | $650.30 |
| Santa Rosa, CACalifornia | — | $669.38 |
| Stockton, CACalifornia | — | $626.66 |
| Vallejo, CACalifornia | — | $696.64 |
| Visalia, CACalifornia | — | $626.66 |
| Yuba City, CACalifornia | — | $626.66 |
| ColoradoColorado | — | $640.25 |
| ConnecticutConnecticut | — | $688.77 |
| DelawareDelaware | — | $627.51 |
| Fort Lauderdale, FLFlorida | — | $724.28 |
| Rest of FloridaFlorida | — | $676.83 |
| Atlanta, GAGeorgia | — | $665.49 |
| Rest of GeorgiaGeorgia | — | $626.68 |
| Hawaii, Guam, HIHawaii | — | $639.15 |
| IowaIowa | — | $554.45 |
| IdahoIdaho | — | $563.51 |
| East St. Louis, ILIllinois | — | $716.89 |
| Rest of IllinoisIllinois | — | $669.90 |
| Suburban Chicago, ILIllinois | — | $726.58 |
| IndianaIndiana | — | $566.90 |
| KansasKansas | — | $561.80 |
| KentuckyKentucky | — | $598.21 |
| New Orleans, LALouisiana | — | $635.80 |
| Rest of LouisianaLouisiana | — | $601.29 |
| Metropolitan Boston, MAMassachusetts | — | $697.06 |
| Rest of MassachusettsMassachusetts | — | $639.50 |
| Baltimore area, MDMaryland | — | $689.29 |
| Rest of MarylandMaryland | — | $637.80 |
| Rest of MaineMaine | — | $578.34 |
| Southern Maine, MEMaine | — | $600.53 |
| Detroit, MIMichigan | — | $697.74 |
| Rest of MichiganMichigan | — | $626.71 |
| MinnesotaMinnesota | — | $578.59 |
| Metropolitan Kansas City, MOMissouri | — | $619.38 |
| Metropolitan St. Louis, MOMissouri | — | $625.76 |
| Rest of MissouriMissouri | — | $595.98 |
| MississippiMississippi | — | $572.29 |
| MontanaMontana | — | $639.76 |
| North CarolinaNorth Carolina | — | $583.93 |
| North DakotaNorth Dakota | — | $580.84 |
| NebraskaNebraska | — | $554.96 |
| New HampshireNew Hampshire | — | $639.82 |
| Northern New JerseyNew Jersey | — | $709.87 |
| Rest of New JerseyNew Jersey | — | $686.83 |
| New MexicoNew Mexico | — | $635.07 |
| NevadaNevada | — | $623.64 |
| NYC suburbs and Long Island, NYNew York | — | $797.34 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $700.18 |
| Queens, NYNew York | — | $753.94 |
| Rest of New YorkNew York | — | $595.40 |
| OhioOhio | — | $614.66 |
| OklahomaOklahoma | — | $585.67 |
| Portland, OROregon | — | $651.62 |
| Rest of OregonOregon | — | $609.20 |
| Metropolitan Philadelphia, PAPennsylvania | — | $675.80 |
| Rest of PennsylvaniaPennsylvania | — | $609.89 |
| Puerto RicoPuerto Rico | — | $641.77 |
| Rhode IslandRhode Island | — | $643.68 |
| South CarolinaSouth Carolina | — | $602.24 |
| TennesseeTennessee | — | $566.58 |
| Austin, TXTexas | — | $646.49 |
| Beaumont, TXTexas | — | $605.90 |
| Brazoria, TXTexas | — | $617.29 |
| Dallas, TXTexas | — | $626.79 |
| Fort Worth, TXTexas | — | $625.09 |
| Galveston, TXTexas | — | $622.67 |
| Houston, TXTexas | — | $677.21 |
| Rest of TexasTexas | — | $615.01 |
| UtahUtah | — | $611.81 |
| VirginiaVirginia | — | $605.60 |
| Virgin Islands, VIUnited States Virgin Islands | — | $641.77 |
| VermontVermont | — | $587.79 |
| Rest of WashingtonWashington | — | $635.20 |
| King County, WAWashington | — | $701.86 |
| WisconsinWisconsin | — | $558.49 |
| West VirginiaWest Virginia | — | $643.57 |
| WyomingWyoming | — | $614.08 |
62256 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 62256 rate is calculated
Each of 62256’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 62256
RVUs × geographic indexes × conversion factor
Work7.20
7.20 RVUs× 1.000 GPCI
Practice expense8.98
8.98 RVUs× 1.000 GPCI
Malpractice2.98
2.98 RVUs× 1.000 GPCI
Adjusted RVUs
19.1600
Conversion factor
$33.4009
Medicare rate
$639.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,941
- Code
- 62256
- Physician work
- 7.20
- Practice expense
- 8.98
- Malpractice
- 2.98
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.20 | × 1.000 | 7.2000 |
| Practice expense | 8.98 | × 1.000 | 8.9800 |
| Malpractice | 2.98 | × 0.336 | 1.0013 |
| Total RVUs | 17.1813 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, South Dakota$573.87
Facility: (7.2 × 1 + 8.98 × 1 + 2.98 × 0.336) × $33.4009 = $573.87
Payment rules and modifiers for 62256
62256 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 62256
Shunt removal, without replacement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 62256
Shunt removal, without replacement
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
62256 without 51 · national facility
$639.96
Shunt removal, without replacement
62256-51 · Second procedure: 50%
$319.98
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 62256 has changed in South Dakota
62256 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $573.87 | RVU26D |
| 2026-07-01 | Not available in this setting | $573.87 | RVU26C |
| 2026-04-01 | Not available in this setting | $573.87 | RVU26B |
| 2026-01-01 | Not available in this setting | $573.87 | RVU26A |
| 2025-10-01 | Not available in this setting | $550.61 | RVU25D |
| 2025-07-01 | Not available in this setting | $550.61 | RVU25C |
| 2025-04-01 | Not available in this setting | $550.61 | RVU25B |
| 2025-01-01 | Not available in this setting | $550.61 | RVU25A |
| 2024-10-01 | Not available in this setting | $564.14 | RVU24D |
| 2024-07-01 | Not available in this setting | $564.14 | RVU24C |
| 2024-04-01 | Not available in this setting | $564.14 | RVU24B |
| 2024-03-09 | Not available in this setting | $564.14 | RVU24AR |
| 2024-01-01 | Not available in this setting | $554.93 | RVU24A |
| 2023-10-01 | Not available in this setting | $564.57 | RVU23D |
| 2023-07-01 | Not available in this setting | $564.57 | RVU23C |
| 2023-04-01 | Not available in this setting | $564.57 | RVU23B |
| 2023-01-01 | Not available in this setting | $564.57 | RVU23A |
| 2022-10-01 | Not available in this setting | $566.44 | RVU22D |
| 2022-07-01 | Not available in this setting | $566.44 | RVU22C |
| 2022-04-01 | Not available in this setting | $566.44 | RVU22B |
| 2022-01-01 | Not available in this setting | $566.44 | RVU22A |
| 2021-10-01 | Not available in this setting | $565.86 | RVU21D |
| 2021-07-01 | Not available in this setting | $565.86 | RVU21C |
| 2021-04-01 | Not available in this setting | $565.86 | RVU21B |
| 2021-01-01 | Not available in this setting | $565.86 | RVU21A |
| 2020-10-01 | Not available in this setting | $565.29 | RVU20D |
| 2020-07-01 | Not available in this setting | $565.29 | RVU20C |
| 2020-04-01 | Not available in this setting | $565.29 | RVU20B |
| 2020-01-01 | Not available in this setting | $565.29 | RVU20A |
| 2019-10-01 | Not available in this setting | $567.17 | RVU19D |
| 2019-07-01 | Not available in this setting | $567.17 | RVU19C |
| 2019-04-01 | Not available in this setting | $567.17 | RVU19B |
| 2019-01-01 | Not available in this setting | $567.17 | RVU19A |
| 2018-10-01 | Not available in this setting | $563.97 | RVU18D |
| 2018-07-01 | Not available in this setting | $563.97 | RVU18C |
| 2018-04-01 | Not available in this setting | $563.97 | RVU18B |
| 2018-01-01 | Not available in this setting | $563.97 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $564.58 | RVU17D |
| 2017-07-01 | Not available in this setting | $564.58 | RVU17C |
| 2017-04-01 | Not available in this setting | $564.58 | RVU17B |
| 2017-01-01 | Not available in this setting | $564.58 | RVU17A |
| 2016-10-01 | Not available in this setting | $563.34 | RVU16D |
| 2016-07-01 | Not available in this setting | $563.34 | RVU16C |
| 2016-04-01 | Not available in this setting | $563.34 | RVU16B |
| 2016-01-01 | Not available in this setting | $563.34 | RVU16A |
| 2015-10-01 | Not available in this setting | $569.98 | RVU15D |
| 2015-07-01 | Not available in this setting | $569.98 | RVU15C |
| 2015-04-01 | Not available in this setting | $567.14 | RVU15B |
| 2015-01-01 | Not available in this setting | $567.14 | RVU15A |
| 2014-10-01 | Not available in this setting | $560.92 | RVU14D |
| 2014-07-01 | Not available in this setting | $560.92 | RVU14C |
| 2014-04-01 | Not available in this setting | $560.92 | RVU14B |
| 2014-01-01 | Not available in this setting | $560.92 | RVU14A |
| 2013-10-01 | Not available in this setting | $561.59 | RVU13D |
| 2013-07-01 | Not available in this setting | $561.59 | RVU13C |
| 2013-04-01 | Not available in this setting | $561.59 | RVU13B |
| 2013-01-01 | Not available in this setting | $561.59 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
62256 billing questions
When should 62256 be reported instead of 62258?
Use 62256 when the complete shunt system is removed without replacement. Use 62258 when the complete system is removed and replaced.
Can 62256 be used for removal of only a shunt catheter?
No. This code describes removal of the complete CSF shunt system; a procedure limited to a catheter or another component is a different service.
What documentation supports reporting 62256?
Document the shunt system components removed and make clear that no replacement was performed. For example, note whether the ventricular catheter, valve, and connected drainage tubing were explanted.
What is the Medicare global period for 62256?
It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid, but co-surgeons and team surgery are not permitted.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for removal of this shunt system.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 62256 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist