$116.82
Both concern implanted spinal or brain drug-pump refill and maintenance. Distinguish 95990’s incident-to, physician-supervised service from 95991 when physician skill is required.
On this page
CMS RVU26D · Effective 2026-10-01
95990 Pump refill Medicare reimbursement rates in Minnesota
Reports refill and maintenance of an implanted drug-delivery pump serving the spinal or brain space, such as a pump used for intrathecal baclofen or pain medication. Compare 95990 office and facility rates across CMS payment localities in Minnesota.
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 95990 in Minnesota?
Minnesota 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
$99.82
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Neurology
About 95990: Intrathecal or intraventricular pump refill
Reports refill and maintenance of an implanted drug-delivery pump serving the spinal or brain space, such as a pump used for intrathecal baclofen or pain medication.
This service replenishes and maintains an implanted pump or reservoir that delivers medication into the spinal space or brain ventricles. Typical patients include people receiving intrathecal baclofen for severe spasticity or implanted-pump medication for chronic pain. A clinician accesses the pump’s refill port, withdraws or accounts for residual medication as appropriate, adds the prescribed drug, and may check pump status as part of the service. It is commonly performed in an outpatient pain-management, rehabilitation, or neurosurgical setting.
Report 95990 for the pump refill and maintenance service, not simply for a medication injection or an office visit. Documentation should identify the implanted pump and delivery site, medication and amount instilled, relevant residual volume, and the work performed. CMS classifies this as an incident-to service: it may be billed only when performed under physician supervision. CMS assigns no work RVU to the code; its listed RVUs include practice expense and malpractice.
CMS billing rules for 95990
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU2.89 · 98%
- Malpractice RVU0.05 · 2%
421
Medicare services in 2024 · #3693 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.
95990 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$97.67
Consider 62369 for a programmable implanted pump when the performed work meets that code’s electronic-analysis, reprogramming, refill, and maintenance criteria; 95990 describes the pump refill and maintenance service.
$97.20
Use the applicable programmable-pump code when electronic analysis and reprogramming accompany refill and maintenance and the work meets 62370’s criteria, rather than treating the encounter as a refill alone.
Compare 95990 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
Minnesota →
Office / nonfacility
$99.82
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 95990 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
12,735
- Code
- 95990
- Physician work
- 0.00
- Practice expense
- 2.89
- Malpractice
- 0.05
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 2.89 | × 1.029 | 2.9738 |
| Malpractice | 0.05 | × 0.296 | 0.0148 |
| Total RVUs | 2.9886 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$99.82
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 2.89 | 1.029 |
| Malpractice | 0.05 | 0.296 |
(0 × 1 + 2.89 × 1.029 + 0.05 × 0.296) × $33.4009 = $99.82
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.
95990 billing questions
When should 95990 be chosen instead of 95991?
Use 95990 for the refill and maintenance service when it is performed under physician supervision as an incident-to service. The related 95991 code is used when the service requires physician skill.
Does 95990 describe an ordinary medication injection?
No. It covers refilling and maintaining an implanted pump or reservoir that delivers medication into the spinal space or brain ventricles, not a separately administered injection.
What documentation supports reporting 95990?
Record the implanted pump and delivery site, the medication and amount placed in the reservoir, relevant residual volume, and the refill and maintenance performed. The record must also support physician supervision for incident-to billing.
Can pump programming be reported with 95990?
Do not use 95990 alone to represent a distinct pump-analysis or reprogramming service. For a programmable pump, select the applicable analysis code based on whether analysis, reprogramming, and refill were performed.
Is 95990 reported per pump or per refill access?
Report the completed pump refill and maintenance service for the encounter; do not count each access maneuver or medication component as a separate unit.
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.
12,73295982,,Io ga n-stim subsq w/reprog,A,,0.63,1.17,,0.23,,0.13,1.93,0.99,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73395983,,Alys brn npgt prgrmg 15 min,A,,0.91,0.56,,0.27,,0.08,1.55,1.26,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73495984,,Alys brn npgt prgrmg addl 15,A,,0.80,0.48,,0.24,,0.07,1.35,1.11,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73595990,,Spin/brain pump refil & main,A,,0.00,2.89,,2.89,NA,0.05,2.94,2.94,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73695991,,Spin/brain pump refil & main,A,,0.75,2.65,,0.19,,0.07,3.47,1.01,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73795992,,Canalith repositioning proc,A,,0.73,0.47,,0.14,,0.02,1.22,0.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,73895999,,Unlisted neurological dx px,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002