Billing code 62252: Shunt reprogrammingMedicare rate & RVUs
A clinician resets an implanted programmable cerebrospinal fluid shunt valve when a setting change is needed to manage CSF drainage or following MRI.
Medicare pays $103.88 for 62252 nationally in the office. Local office rates run $89.40–$133.33.
Medicare rate · 62252
Shunt reprogramming
Swap in your local Medicare rate.
- Work RVUs
- 0.72
- Total RVUs
- 3.11
- Global days
- XXX
National rate · 2026
$103.88
Office setting, before claim adjustments.
See every locality for 62252 → · 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
What 62252 covers
A neurosurgical clinician uses an external programmer to change the setting of an implanted programmable CSF shunt valve. This service is used for patients with conditions such as hydrocephalus when the prescribed drainage setting needs adjustment; it may also be needed after MRI if the scan affects the valve setting. Reprogramming is performed in office or hospital outpatient settings and does not involve surgically replacing the shunt.
Report the service per day, rather than once for each setting change. Documentation should identify the programmable valve, the reason for adjustment, and the setting before and after reprogramming. CMS treats this as a diagnostic test with professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global 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.
Where 62252 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$89.40 to $133.33
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $91.01 | Unavailable |
| Alaska* | $116.28 | Unavailable |
| Arizona | $100.35 | Unavailable |
| Arkansas | $89.40 | Unavailable |
| Atlanta | $106.96 | Unavailable |
| Austin | $106.95 | Unavailable |
| Bakersfield | $107.44 | Unavailable |
| Baltimore/Surr. Cntys | $111.62 | Unavailable |
| Beaumont | $96.87 | Unavailable |
| Brazoria | $101.38 | Unavailable |
| Chicago | $116.51 | Unavailable |
| Chico | $106.71 | Unavailable |
| Colorado | $106.63 | Unavailable |
| Connecticut | $111.75 | Unavailable |
| Dallas | $102.48 | Unavailable |
| Dc + Md/Va Suburbs | $118.78 | Unavailable |
| Delaware | $102.21 | Unavailable |
| Detroit | $107.83 | Unavailable |
| East St. Louis | $107.72 | Unavailable |
| El Centro | $106.76 | Unavailable |
| Fort Lauderdale | $112.35 | Unavailable |
| Fort Worth | $101.90 | Unavailable |
| Fresno | $106.71 | Unavailable |
| Galveston | $101.97 | Unavailable |
| Hanford-Corcoran | $106.71 | Unavailable |
| Hawaii, Guam | $109.59 | Unavailable |
| Houston | $107.09 | Unavailable |
| Idaho | $93.31 | Unavailable |
| Indiana | $93.93 | Unavailable |
| Iowa | $92.25 | Unavailable |
| Kansas | $92.47 | Unavailable |
| Kentucky | $95.26 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $114.62 | Unavailable |
| Madera | $106.71 | Unavailable |
| Manhattan | $122.31 | Unavailable |
| Merced | $106.71 | Unavailable |
| Metropolitan Boston | $117.51 | Unavailable |
| Metropolitan Kansas City | $99.36 | Unavailable |
| Metropolitan Philadelphia | $109.00 | Unavailable |
| Metropolitan St. Louis | $100.51 | Unavailable |
| Miami | $121.07 | Unavailable |
| Minnesota | $99.34 | Unavailable |
| Mississippi | $91.64 | Unavailable |
| Modesto | $106.71 | Unavailable |
| Montana** | $103.86 | Unavailable |
| Napa | $123.20 | Unavailable |
| Nebraska | $92.63 | Unavailable |
| Nevada** | $102.39 | Unavailable |
| New Hampshire | $105.60 | Unavailable |
| New Mexico | $99.91 | Unavailable |
| New Orleans | $100.99 | Unavailable |
| North Carolina | $95.78 | Unavailable |
| North Dakota** | $98.32 | Unavailable |
| Northern Nj | $117.30 | Unavailable |
| Nyc Suburbs/Long Island | $126.75 | Unavailable |
| Ohio | $97.82 | Unavailable |
| Oklahoma | $94.25 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $113.85 | Unavailable |
| Portland | $109.69 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $113.62 | Unavailable |
| Puerto Rico | $104.51 | Unavailable |
| Queens | $122.38 | Unavailable |
| Redding | $106.71 | Unavailable |
| Rest Of California | $106.71 | Unavailable |
| Rest Of Florida | $105.48 | Unavailable |
| Rest Of Georgia | $98.06 | Unavailable |
| Rest Of Illinois | $103.01 | Unavailable |
| Rest Of Louisiana | $95.38 | Unavailable |
| Rest Of Maine | $94.70 | Unavailable |
| Rest Of Maryland | $104.20 | Unavailable |
| Rest Of Massachusetts | $106.10 | Unavailable |
| Rest Of Michigan | $98.95 | Unavailable |
| Rest Of Missouri | $93.91 | Unavailable |
| Rest Of New Jersey | $112.23 | Unavailable |
| Rest Of New York | $97.58 | Unavailable |
| Rest Of Oregon | $100.82 | Unavailable |
| Rest Of Pennsylvania | $97.58 | Unavailable |
| Rest Of Texas | $99.38 | Unavailable |
| Rest Of Washington | $105.69 | Unavailable |
| Rhode Island | $105.65 | Unavailable |
| Riverside-San Bernardino-Ontario | $109.70 | Unavailable |
| Sacramento-Roseville-Folsom | $111.89 | Unavailable |
| Salinas | $111.49 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $114.13 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $130.00 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $129.68 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $133.33 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $132.03 | Unavailable |
| San Luis Obispo-Paso Robles | $109.74 | Unavailable |
| Santa Cruz-Watsonville | $115.19 | Unavailable |
| Santa Maria-Santa Barbara | $111.91 | Unavailable |
| Santa Rosa-Petaluma | $116.33 | Unavailable |
| Seattle (King Cnty) | $119.37 | Unavailable |
| South Carolina | $97.12 | Unavailable |
| South Dakota** | $97.67 | Unavailable |
| Southern Maine | $99.79 | Unavailable |
| Stockton | $106.71 | Unavailable |
| Suburban Chicago | $113.17 | Unavailable |
| Tennessee | $93.13 | Unavailable |
| Utah | $98.69 | Unavailable |
| Vallejo | $122.74 | Unavailable |
| Vermont | $98.55 | Unavailable |
| Virgin Islands | $104.51 | Unavailable |
| Virginia | $99.93 | Unavailable |
| Visalia | $106.71 | Unavailable |
| West Virginia | $98.68 | Unavailable |
| Wisconsin | $94.45 | Unavailable |
| Wyoming** | $101.45 | Unavailable |
| Yuba City | $106.71 | Unavailable |
62252 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.
$89.40
$120.02
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $116.28 | 1 |
| AL | $91.01 | 1 |
| AR | $89.40 | 1 |
| AZ | $100.35 | 1 |
| CA | $106.71–$133.33 | 29 |
| CO | $106.63 | 1 |
| CT | $111.75 | 1 |
| DC | $118.78 | 1 |
| DE | $102.21 | 1 |
| FL | $105.48–$121.07 | 3 |
| GA | $98.06–$106.96 | 2 |
| GU | $109.59 | 1 |
| HI | $109.59 | 1 |
| IA | $92.25 | 1 |
| ID | $93.31 | 1 |
| IL | $103.01–$116.51 | 4 |
| IN | $93.93 | 1 |
| KS | $92.47 | 1 |
| KY | $95.26 | 1 |
| LA | $95.38–$100.99 | 2 |
| MA | $106.10–$117.51 | 2 |
| MD | $104.20–$118.78 | 3 |
| ME | $94.70–$99.79 | 2 |
| MI | $98.95–$107.83 | 2 |
| MN | $99.34 | 1 |
| MO | $93.91–$100.51 | 3 |
| MS | $91.64 | 1 |
| MT | $103.86 | 1 |
| NC | $95.78 | 1 |
| ND | $98.32 | 1 |
| NE | $92.63 | 1 |
| NH | $105.60 | 1 |
| NJ | $112.23–$117.30 | 2 |
| NM | $99.91 | 1 |
| NV | $102.39 | 1 |
| NY | $97.58–$126.75 | 5 |
| OH | $97.82 | 1 |
| OK | $94.25 | 1 |
| OR | $100.82–$109.69 | 2 |
| PA | $97.58–$109.00 | 2 |
| PR | $104.51 | 1 |
| RI | $105.65 | 1 |
| SC | $97.12 | 1 |
| SD | $97.67 | 1 |
| TN | $93.13 | 1 |
| TX | $96.87–$107.09 | 8 |
| UT | $98.69 | 1 |
| VA | $99.93–$118.78 | 2 |
| VI | $104.51 | 1 |
| VT | $98.55 | 1 |
| WA | $105.69–$119.37 | 2 |
| WI | $94.45 | 1 |
| WV | $98.68 | 1 |
| WY | $101.45 | 1 |
How the 62252 rate is calculated
Each of 62252’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 · 62252
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.72Practice expense 2.11Malpractice 0.28
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 62252
The CMS indicators that decide how 62252 is paid alongside other services.
CMS payment indicators · 62252
Shunt reprogramming
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
62252 without 26 · national office
$103.88
Shunt reprogramming
62252-26 · Professional component
$49.43
Pays only the interpretation and report.
62252 compared with similar codes
Compare codes
62252 vs 62230 vs 62225: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 62230Shunt revision
- Use 62252 for an external adjustment of a programmable valve. Code 62230 describes surgical revision or replacement of shunt components.
- 62225Ventricular catheter
- Code 62225 concerns replacement or irrigation of a ventricular catheter; 62252 changes a programmable valve setting without catheter replacement or irrigation.
62252 billing questions
How is reprogramming different from shunt revision?
Report 62252 when the implanted programmable valve is adjusted with an external programmer. A physical shunt or catheter revision is a different service, such as the work described by 62230.
Is the code reported for each adjustment?
No. It is reported per day, not per setting change. Document the adjustment or adjustments performed that day.
Which modifiers identify the components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical component, including equipment and staff. Reporting without either modifier represents the global service.
Can reprogramming be reported with an MRI?
Yes, when an MRI is performed and the programmable valve also requires a setting check or adjustment. The MRI and the reprogramming are distinct services.
What documentation supports the service?
Record that the shunt has a programmable valve, why its setting needed attention, and the setting before and after the adjustment.
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
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