$197.94
Both codes describe diagnostic lumbar access, but 62328 is selected when fluoroscopic or CT guidance is used.
On this page
CMS RVU26D · Effective 2026-10-01
62270 Lumbar puncture Medicare reimbursement rates in Kentucky
Reports a diagnostic lumbar puncture to collect cerebrospinal fluid or measure pressure during evaluation of neurologic or infectious conditions. Compare 62270 office and facility rates across CMS payment localities in Kentucky.
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 62270 in Kentucky?
Kentucky 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
$151.35
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$56.92
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
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.
Spinal procedure
About 62270: Diagnostic lumbar puncture
Reports a diagnostic lumbar puncture to collect cerebrospinal fluid or measure pressure during evaluation of neurologic or infectious conditions.
A clinician places a needle into the lumbar subarachnoid space to obtain cerebrospinal fluid for testing or to measure cerebrospinal fluid pressure. Neurologists, emergency physicians, hospitalists, and other qualified practitioners commonly perform the procedure in an office, emergency department, or hospital. Typical indications include evaluation for meningitis, subarachnoid hemorrhage, inflammatory disease, or disorders involving raised intracranial pressure.
Choose this code for a diagnostic lumbar puncture without fluoroscopic or CT guidance. Use the documented reason for the procedure, lumbar access, and diagnostic purpose to support the claim; fluid tubes or laboratory tests do not represent additional punctures. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and applies its standard reduction to the others. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 62270
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.19 · 24%
- Practice expense (office) RVU3.46 · 70%
- Malpractice RVU0.29 · 6%
21.9K
Medicare services in 2024 · #1112 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.
62270 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$198.83
62270 is for diagnostic evaluation, including fluid collection or pressure measurement; 62272 is for therapeutic cerebrospinal fluid drainage.
$165.75
62284 reports lumbar injection of contrast for myelography or CT cisternography; 62270 reports a diagnostic puncture for cerebrospinal fluid evaluation.
Compare 62270 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
Kentucky →
Office / nonfacility
$151.35
Facility
$56.92
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 62270 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,948
- Code
- 62270
- Physician work
- 1.19
- Practice expense
- 3.46
- Malpractice
- 0.29
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.19 | × 1.000 | 1.1900 |
| Practice expense | 3.46 | × 0.889 | 3.0759 |
| Malpractice | 0.29 | × 0.915 | 0.2653 |
| Total RVUs | 4.5313 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$151.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.19 | 1 |
| Practice expense | 3.46 | 0.889 |
| Malpractice | 0.29 | 0.915 |
(1.19 × 1 + 3.46 × 0.889 + 0.29 × 0.915) × $33.4009 = $151.35
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.19 | 1 |
| Practice expense | 0.28 | 0.889 |
| Malpractice | 0.29 | 0.915 |
(1.19 × 1 + 0.28 × 0.889 + 0.29 × 0.915) × $33.4009 = $56.92
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.
62270 billing questions
How does this differ from code 62328?
Use 62270 for a diagnostic lumbar puncture without fluoroscopic or CT guidance. Code 62328 is for a diagnostic lumbar puncture performed with fluoroscopic or CT guidance.
When should 62272 be reported instead?
Use 62272 when the purpose is therapeutic drainage of cerebrospinal fluid. Code 62270 represents a diagnostic puncture, such as obtaining fluid for evaluation or measuring pressure.
Can each cerebrospinal fluid tube be billed as a separate unit?
No. Multiple collection tubes from one lumbar puncture do not represent multiple punctures. Report laboratory testing separately when those tests are performed.
Should modifier 50 be used for bilateral lumbar punctures?
No. Medicare's bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How does Medicare handle this with another procedure in the same session?
Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and reduces payment for the other procedures. Same-day preoperative and postoperative care is included in this code's 0-day global period.
What documentation supports reporting 62270?
Document the diagnostic indication, lumbar access, and the procedure performed, including fluid collection or pressure measurement when applicable. The record should distinguish diagnostic evaluation from therapeutic drainage.
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.
6,94562267,,Interdiscal perq aspir dx,A,,2.93,4.49,,0.78,,0.33,7.75,4.04,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94662268,,Drain spinal cord cyst,A,,4.61,2.98,NA,2.98,,1.94,9.53,9.53,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94762269,,Needle biopsy spinal cord,A,,4.88,1.31,NA,1.31,,0.46,6.65,6.65,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94862270,,Dx lmbr spi pnxr,A,,1.19,3.46,,0.28,,0.29,4.94,1.76,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94962272,,Ther spi pnxr drg csf,A,,1.54,4.48,,0.53,,0.47,6.49,2.54,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,95062273,,Inject epidural patch,A,,2.10,2.84,,0.75,,0.21,5.15,3.06,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,95162280,,Treat spinal cord lesion,A,,2.56,6.90,,1.26,,0.26,9.72,4.08,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631