Billing code 62369: Pump managementMedicare rate & RVUs
Reports electronic analysis, reprogramming, and medication-reservoir refill of an implanted intrathecal or epidural infusion pump.
Medicare pays $97.20 for 62369 nationally in the office and $29.73 in a hospital or facility. Local office rates run $85.75–$130.83.
Medicare rate · 62369
Pump management
Swap in your local Medicare rate.
- Work RVUs
- 0.65
- Total RVUs
- 2.91
- Global days
- XXX
National rate · 2026
$97.20
Office setting, before claim adjustments.
See every locality for 62369 → · 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 62369 covers
This service covers electronic interrogation of an implanted programmable pump that delivers medication into the intrathecal or epidural space, review of its operating information, adjustment of its settings, and refill of its reservoir. It is used for patients with implanted systems delivering medication such as intrathecal baclofen or pain medication. Pain specialists, neurosurgeons, and other clinicians who manage these pumps commonly provide the service in an office or facility setting.
Report 62369 when the encounter includes the pump analysis, a programming change, and a refill, and the work meets this code’s provider-performance criteria. The distinction from 62370 is whether the service requires physician or other qualified health care professional skill; match the code to who performed the work and the documentation. The record should support the pump’s status review, the programming performed, the medication and amount used to refill the reservoir, and the clinical need for the visit. This code represents the combined refill-and-reprogramming service, not analysis alone or analysis with programming but no refill.
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 62369 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
$85.75 to $130.83
109 of 109 payment localities
62369 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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.
$85.75
$117.17
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 | $111.76 | 1 |
| AL | $87.04 | 1 |
| AR | $85.75 | 1 |
| AZ | $94.59 | 1 |
| CA | $103.50–$130.83 | 29 |
| CO | $101.63 | 1 |
| CT | $103.75 | 1 |
| DC | $111.65 | 1 |
| DE | $96.19 | 1 |
| FL | $95.15–$103.77 | 3 |
| GA | $89.75–$98.90 | 2 |
| GU | $106.23 | 1 |
| HI | $106.23 | 1 |
| IA | $89.57 | 1 |
| ID | $90.11 | 1 |
| IL | $92.15–$101.13 | 4 |
| IN | $90.66 | 1 |
| KS | $89.01 | 1 |
| KY | $88.88 | 1 |
| LA | $88.69–$93.20 | 2 |
| MA | $100.95–$112.02 | 2 |
| MD | $98.10–$111.65 | 3 |
| ME | $90.46–$95.68 | 2 |
| MI | $91.13–$96.24 | 2 |
| MN | $97.67 | 1 |
| MO | $87.04–$93.69 | 3 |
| MS | $86.42 | 1 |
| MT | $97.19 | 1 |
| NC | $91.45 | 1 |
| ND | $95.81 | 1 |
| NE | $90.11 | 1 |
| NH | $99.90 | 1 |
| NJ | $105.02–$110.43 | 2 |
| NM | $91.60 | 1 |
| NV | $96.88 | 1 |
| NY | $92.84–$114.41 | 5 |
| OH | $90.85 | 1 |
| OK | $88.85 | 1 |
| OR | $96.21–$105.06 | 2 |
| PA | $91.07–$101.04 | 2 |
| PR | $97.97 | 1 |
| RI | $99.77 | 1 |
| SC | $91.29 | 1 |
| SD | $95.64 | 1 |
| TN | $89.46 | 1 |
| TX | $90.45–$101.22 | 8 |
| UT | $92.57 | 1 |
| VA | $95.27–$111.65 | 2 |
| VI | $97.97 | 1 |
| VT | $95.31 | 1 |
| WA | $100.80–$114.46 | 2 |
| WI | $92.51 | 1 |
| WV | $88.62 | 1 |
| WY | $96.59 | 1 |
How the 62369 rate is calculated
Each of 62369’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 · 62369
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.65Practice expense 2.19Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 62369
62369 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 62369
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$97.20
The facility rate would be $29.73 (+$67.47). In a facility, the facility bills its own costs separately.
62369 compared with similar codes
Compare codes
62369 vs 62367 vs 62368 vs 62370: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 62367Pump analysis
- Choose 62367 when the pump is analyzed but neither reprogrammed nor refilled. It does not describe the combined refill-and-reprogramming service.
- 62368Pump analysis
- Choose 62368 when analysis and reprogramming occur without a reservoir refill. A refill during the service points to the refill-and-reprogramming code family.
- 62370Pump refill
- Both codes include pump analysis, reprogramming, and refill. Distinguish them by whether the service requires physician or other qualified health care professional skill and by who performed the work.
62369 billing questions
When should 62369 be chosen instead of 62368?
Use 62369 when the pump is reprogrammed and its reservoir is refilled. Code 62368 describes pump analysis with reprogramming but without a refill.
How does 62369 differ from 62370?
Both describe pump analysis with reprogramming and refill. The distinction is whether the service requires physician or other qualified health care professional skill; select the code supported by the performer and documented work.
Does this code include the pump analysis and refill?
Yes. The reported service includes electronic pump analysis, reprogramming, and reservoir refill when all three are performed.
What documentation supports 62369?
Document the pump status reviewed, the programming change, the medication and refill amount, and who performed the work. The record should establish that a refill and reprogramming occurred during the service.
Can 62369 be reported when the pump is only checked?
No. Analysis without reprogramming or refill is represented by 62367; analysis with reprogramming but no refill is represented by 62368.
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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