No office rate
Use 62258 when the complete CSF shunt system is removed and replaced. Use 62256 when removal is performed without replacement.
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CMS RVU26D · Effective 2026-10-01
62256 Shunt removal Medicare reimbursement rates in New Jersey
Reports surgical removal of a complete cerebrospinal fluid shunt system when the system is taken out without replacement. Compare 62256 office and facility rates across CMS payment localities in New Jersey.
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 62256 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$686.83–$709.87
2 of 2 localities have a 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.
Neurosurgery
About 62256: Complete cerebrospinal fluid shunt removal
Reports surgical removal of a complete cerebrospinal fluid shunt system when the system is taken out without replacement.
A neurosurgeon surgically removes the complete CSF diversion system, including its intracranial catheter and connected valve and drainage tubing. A common example is explantation of a ventriculoperitoneal shunt because of infection when the shunt is not replaced during the procedure. The service is generally performed in an operating room; it is distinct from revising one component or adjusting a programmable valve.
Report 62256 when the complete shunt system is removed and no replacement is performed. If a complete system is removed and replaced, compare 62258; if only a catheter or other shunt component is revised, consider the code for that service instead. Documentation should identify the shunt components removed and clarify whether replacement occurred. The 90-day global period includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Do not append modifier 50 for this service.
CMS billing rules for 62256
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.20 · 38%
- Practice expense (office) RVU8.98 · 47%
- Malpractice RVU2.98 · 16%
563
Medicare services in 2024 · #3453 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.
62256 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
62230 addresses revision or replacement of shunt hardware; 62256 is for removal of the complete system without replacement.
No office rate
62225 concerns ventricular catheter replacement or irrigation, not explantation of the complete shunt system.
$112.23–$117.30
62252 is valve reprogramming, a non-explant service; 62256 involves surgical removal of the complete shunt system.
Compare 62256 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
Unavailable
Facility
$709.87
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$686.83
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62256 billing questions
When should 62256 be reported instead of 62258?
Use 62256 when the complete shunt system is removed without replacement. Use 62258 when the complete system is removed and replaced.
Can 62256 be used for removal of only a shunt catheter?
No. This code describes removal of the complete CSF shunt system; a procedure limited to a catheter or another component is a different service.
What documentation supports reporting 62256?
Document the shunt system components removed and make clear that no replacement was performed. For example, note whether the ventricular catheter, valve, and connected drainage tubing were explanted.
What is the Medicare global period for 62256?
It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant at surgery may be paid, but co-surgeons and team surgery are not permitted.
Should modifier 50 be appended?
No. Modifier 50 is inappropriate for removal of this shunt system.
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.
6,93862252,,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
6,94262258,,Replace brain cavity shunt,A,,15.25,11.77,NA,11.77,,6.07,33.09,33.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94362263,,Epidural lysis mult sessions,A,,4.88,14.56,,3.59,,0.46,19.90,8.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,94462264,,Epidural lysis on single day,A,,4.31,8.64,,1.68,,0.42,13.37,6.41,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00