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Billing code 36261: Pump revisionMedicare rate & RVUs

Report surgical revision or repositioning of an implanted infusion pump, such as when the pump requires correction or relocation rather than insertion or removal.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $407.49 for 36261 nationally in a facility.

Medicare rate · 36261

Pump revision

Swap in your local Medicare rate.

Work RVUs
5.49
Total RVUs
12.20
Global days
090

National rate · 2026

$407.49

Facility setting, before claim adjustments.

See every locality for 36261 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 36261 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 36261 covers

This service covers an operation to revise or reposition an implanted infusion pump. A surgeon, often a neurosurgeon or pain specialist, may address a pump that has shifted, is poorly positioned in its pocket, or needs surgical correction. Implanted pumps commonly deliver medication into the intrathecal space, including baclofen for severe spasticity or medication for chronic pain. The procedure is typically performed in a hospital or ambulatory surgical setting.

Report this code when the operative work is on the implanted pump itself, rather than inserting a new pump or removing one. The operative report should identify the pump problem and describe the revision or repositioning performed; document catheter work separately when it is also done. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are 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 36261 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

36261 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$364.41
Alaska*Unavailable$488.68
ArizonaUnavailable$395.03
ArkansasUnavailable$359.11
AtlantaUnavailable$420.65
AustinUnavailable$412.47
BakersfieldUnavailable$408.74
Baltimore/Surr. CntysUnavailable$434.78
BeaumontUnavailable$388.25
BrazoriaUnavailable$396.65

36261 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
36261 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 36261 rate is calculated

Each of 36261’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 · 36261

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.49Practice expense 5.25Malpractice 1.46

12.2000 adjusted RVUs×$33.4009 conversion factor=$407.49

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 36261

36261 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36261

Pump revision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 36261

Pump revision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36261 without 51 · national facility

$407.49

Pump revision

36261-51 · Second procedure: 50%

$203.75

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%).

When to use modifier 51

36261 compared with similar codes

Compare codes

36261 vs 36260 vs 36262 vs 62350 vs 62362: national Medicare rates

Swap in your local Medicare rate.

  • 36261
    Pump revision · 5.49 wRVU
    —
  • 36260
    Pump insertion · 9.66 wRVU
    —
  • 36262
    Infusion pump removal · 4.01 wRVU
    —
  • 62350
    Spinal catheter · 5.9 wRVU
    —
  • 62362
    Infusion pump implant · 5.46 wRVU
    —

How to choose

36260Pump insertion
Choose 36260 for insertion or replacement of the implanted pump; choose 36261 when the operation revises or repositions an existing pump.
36262Infusion pump removal
36262 describes removal of the implanted pump. 36261 describes revision or repositioning when the pump is not simply being removed.
62350Spinal catheter
62350 addresses tunneled intrathecal or epidural catheter work. Use 36261 for revision or repositioning of the implanted pump itself.
62362Infusion pump implant
62362 is for electronic analysis or reprogramming of a programmable implanted pump, not operative revision or repositioning.

Codes related to 36261

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 36261
CodeHow it relatesNational office range
Same family
36260Pump insertionInsertion or replacement of an implanted infusion pump, rather than revision or repositioning.No office rate
36262Infusion pump removalRemoval of an implanted infusion pump.No office rate
Often billed with
62350Spinal catheterCatheter implantation, revision, or repositioning may be a separate service when catheter work is also performed.No office rate
62362Infusion pump implantPump analysis or reprogramming is distinct from surgical revision when separately performed and documented.No office rate

36261 billing questions

When should I report 36261 instead of 36260?

Use 36261 for surgical revision or repositioning of an implanted pump. Use 36260 when inserting or replacing the pump.

When is 36262 more appropriate?

Report 36262 when the implanted pump is removed. Revision or repositioning of a pump that remains implanted is the distinction for 36261.

Does pump revision include catheter revision?

Document pump work and catheter work separately. If the surgeon also revises the intrathecal or epidural catheter, consider the applicable catheter procedure code for that distinct work.

Should modifier 50 be appended for work on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.

How does the global period affect postoperative visits?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.

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
RVUs for 36261PPRRVU2026_Oct_nonQPP.csv, line 4,464 (RVU26D)

Open CMS sourceHow we calculate rates

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