No office rate
Choose 36260 for insertion or replacement of the implanted pump; choose 36261 when the operation revises or repositions an existing pump.
On this page
CMS RVU26D · Effective 2026-10-01
36261 Pump revision Medicare reimbursement rates in Pennsylvania
Report surgical revision or repositioning of an implanted infusion pump, such as when the pump requires correction or relocation rather than insertion or removal. Compare 36261 office and facility rates across CMS payment localities in Pennsylvania.
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 36261 in Pennsylvania?
Pennsylvania 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
$390.43–$427.39
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.
Infusion pump surgery
About 36261: Implanted infusion pump revision
Report surgical revision or repositioning of an implanted infusion pump, such as when the pump requires correction or relocation rather than insertion or removal.
This service covers an operation to revise or reposition an implanted infusion pump. A surgeon, often a neurosurgeon or pain specialist, may address a pump that has shifted, is poorly positioned in its pocket, or needs surgical correction. Implanted pumps commonly deliver medication into the intrathecal space, including baclofen for severe spasticity or medication for chronic pain. The procedure is typically performed in a hospital or ambulatory surgical setting.
Report this code when the operative work is on the implanted pump itself, rather than inserting a new pump or removing one. The operative report should identify the pump problem and describe the revision or repositioning performed; document catheter work separately when it is also done. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 36261
- 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 RVU5.49 · 45%
- Practice expense (office) RVU5.25 · 43%
- Malpractice RVU1.46 · 12%
14
Medicare services in 2024 · #6098 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.
36261 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
36262 describes removal of the implanted pump. 36261 describes revision or repositioning when the pump is not simply being removed.
No office rate
62350 addresses tunneled intrathecal or epidural catheter work. Use 36261 for revision or repositioning of the implanted pump itself.
No office rate
62362 is for electronic analysis or reprogramming of a programmable implanted pump, not operative revision or repositioning.
Compare 36261 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$427.39
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$390.43
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36261 billing questions
When should I report 36261 instead of 36260?
Use 36261 for surgical revision or repositioning of an implanted pump. Use 36260 when inserting or replacing the pump.
When is 36262 more appropriate?
Report 36262 when the implanted pump is removed. Revision or repositioning of a pump that remains implanted is the distinction for 36261.
Does pump revision include catheter revision?
Document pump work and catheter work separately. If the surgeon also revises the intrathecal or epidural catheter, consider the applicable catheter procedure code for that distinct work.
Should modifier 50 be appended for work on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
How does the global period affect postoperative visits?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.
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.
4,46136253,,Ins cath ren art 2nd+ unilat,A,,7.12,48.81,,1.13,,0.88,56.81,9.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46236254,,Ins cath ren art 2nd+ bilat,A,,7.70,47.75,,1.42,,1.73,57.18,10.85,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46336260,,Insertion of infusion pump,A,,9.66,6.72,NA,6.72,,2.58,18.96,18.96,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46436261,,Revision of infusion pump,A,,5.49,5.25,NA,5.25,,1.46,12.20,12.20,0,090,0.09,0.84,0.07,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46536262,,Removal of infusion pump,A,,4.01,4.38,NA,4.38,,1.08,9.47,9.47,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46636299,,Unlisted px vascular njx,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,46736400,,Vnpnxr<3yrs phy/qhp fem/jug,A,,0.37,0.43,,0.08,,0.02,0.82,0.47,0,XXX,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00