Billing code 62369: Pump managementMedicare rate & RVUs in Maine
Reports electronic analysis, reprogramming, and medication-reservoir refill of an implanted intrathecal or epidural infusion pump.
Medicare pays $90.46–$95.68 for 62369 in the office in Maine, from Rest Of Maine to Southern Maine. Which amount applies depends on the service address.
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 9 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 in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $90.46 | $28.39 |
| Southern Maine | $95.68 | $28.81 |
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
Work0.65
0.65 RVUs× 1.000 GPCI
Practice expense2.19
2.19 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.9100
Conversion factor
$33.4009
Medicare rate
$97.20
Every GPCI starts 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).
POS 11 · non-facility rate · national
$97.20
- Non-facility (office)
- $97.20
- Facility
- $29.73
Higher because the practice carries its own overhead.
62369 compared with similar codes
Compare codes · National
4 codes, side by side
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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