CPT code 62258: Shunt exchange, complete system replacement2026 Medicare rate & RVUs in Maryland
Reports operative removal and replacement of an entire cerebrospinal fluid shunt system, rather than revision of an individual catheter or shunt component.
CMS doesn’t publish an office rate for 62258 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 62258 covers
A neurosurgeon removes the existing cerebrospinal fluid shunt system and places a replacement system during the same operation. The system may include a ventricular catheter, valve, and distal tubing that drains cerebrospinal fluid to another body cavity. This service is typically performed in a hospital operating room when the complete shunt requires exchange, such as for malfunction or another condition requiring removal and immediate replacement.
Report this code when the operative record supports removal and replacement of the complete system; a procedure limited to a ventricular catheter, valve, or distal catheter calls for a different code. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 62258 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,190.13 |
| Rest of Maryland | Unavailable | $1,098.42 |
| Washington, DC area | Unavailable | $1,225.63 |
How the 62258 rate is calculated
Each of 62258’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 · 62258
RVUs × geographic indexes × conversion factor
Work15.25
15.25 RVUs× 1.000 GPCI
Practice expense11.77
11.77 RVUs× 1.000 GPCI
Malpractice6.07
6.07 RVUs× 1.000 GPCI
Adjusted RVUs
33.0900
Conversion factor
$33.4009
Medicare rate
$1,105.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 62258
62258 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 62258
Shunt exchange, complete system 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) | 1 | Permitted with supporting documentation. |
| 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 · 62258
Shunt exchange, complete system 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
62258 without 51 · national facility
$1,105.24
Shunt exchange, complete system replacement
62258-51 · Second procedure: 50%
$552.62
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%).
62258 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 62256Shunt removalWithout replacement
- Use 62256 when the complete system is removed without replacement. This code describes removal followed by replacement during the operation.
- 62230Shunt revisionComponent revision, not full-system replacement
- Use 62230 for revision or replacement of a shunt or a component. This code is for exchange of the complete system.
- 62225Ventricular catheterReplacement or irrigation
- Use 62225 for ventricular catheter replacement or irrigation, not removal and replacement of the complete shunt system.
- 62223CSF shunt creationPeritoneal, pleural, or other terminus
- Use 62223 when establishing a shunt, rather than exchanging an existing complete system.
62258 billing questions
When is this code appropriate instead of 62230?
Use this code when the operation removes and replaces the complete shunt system. Code 62230 describes revision or replacement of a shunt or a component rather than complete system exchange.
How does this differ from 62256?
This code describes complete system removal with replacement during the operation. Code 62256 is for complete system removal without replacement.
Can a ventricular catheter replacement be reported with this code?
A procedure limited to ventricular catheter replacement or irrigation is distinct from complete system exchange and is described by 62225. The operative report should identify which components were removed and replaced.
What documentation supports complete system replacement?
Document removal of the existing complete shunt system and placement of the replacement system, including the components addressed and the clinical reason for exchange.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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