No office rate
Use 62252 for an external adjustment of a programmable valve. Code 62230 describes surgical revision or replacement of shunt components.
On this page
CMS RVU26D · Effective 2026-10-01
62252 Shunt reprogramming Medicare reimbursement rates in Alabama
A clinician resets an implanted programmable cerebrospinal fluid shunt valve when a setting change is needed to manage CSF drainage or following MRI. Compare 62252 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 62252 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$91.01
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Neurosurgical device management
About 62252: Programmable CSF shunt valve adjustment
A clinician resets an implanted programmable cerebrospinal fluid shunt valve when a setting change is needed to manage CSF drainage or following MRI.
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.
CMS billing rules for 62252
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.72 · 23%
- Practice expense (office) RVU2.11 · 68%
- Malpractice RVU0.28 · 9%
9.7K
Medicare services in 2024 · #1483 by national volume
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.
62252 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Code 62225 concerns replacement or irrigation of a ventricular catheter; 62252 changes a programmable valve setting without catheter replacement or irrigation.
Compare 62252 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$91.01
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 62252 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,938
- Code
- 62252
- Physician work
- 0.72
- Practice expense
- 2.11
- Malpractice
- 0.28
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.72 | × 1.000 | 0.7200 |
| Practice expense | 2.11 | × 0.875 | 1.8462 |
| Malpractice | 0.28 | × 0.566 | 0.1585 |
| Total RVUs | 2.7247 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$91.01
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.72 | 1 |
| Practice expense | 2.11 | 0.875 |
| Malpractice | 0.28 | 0.566 |
(0.72 × 1 + 2.11 × 0.875 + 0.28 × 0.566) × $33.4009 = $91.01
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,93562223,,Establish brain cavity shunt,A,,13.70,11.87,NA,11.87,,5.07,30.64,30.64,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,93662225,,Replace/irrigate catheter,A,,6.04,8.58,NA,8.58,,2.51,17.13,17.13,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,93762230,,Replace/revise brain shunt,A,,11.14,9.63,NA,9.63,,4.36,25.13,25.13,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,93862252,,Csf shunt reprogram,A,,0.72,2.11,,2.11,NA,0.28,3.11,3.11,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,93962252,26,Csf shunt reprogram,A,,0.72,0.49,,0.49,,0.27,1.48,1.48,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94062252,TC,Csf shunt reprogram,A,,0.00,1.62,,1.62,NA,0.01,1.63,1.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
6,94162256,,Remove brain cavity shunt,A,,7.20,8.98,NA,8.98,,2.98,19.16,19.16,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515