No office rate
Use 62256 when the complete system is removed without replacement. This code describes removal followed by replacement during the operation.
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CMS RVU26D · Effective 2026-10-01
62258 Shunt exchange Medicare reimbursement rates in Texas
Reports operative removal and replacement of an entire cerebrospinal fluid shunt system, rather than revision of an individual catheter or shunt component. Compare 62258 office and facility rates across CMS payment localities in Texas.
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 62258 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
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.
Where 62258 pays more and less in Texas
Neurosurgery
About 62258: Complete cerebrospinal fluid shunt exchange
Reports operative removal and replacement of an entire cerebrospinal fluid shunt system, rather than revision of an individual catheter or shunt component.
A neurosurgeon removes the existing cerebrospinal fluid shunt system and places a replacement system during the same operation. The system may include a ventricular catheter, valve, and distal tubing that drains cerebrospinal fluid to another body cavity. This service is typically performed in a hospital operating room when the complete shunt requires exchange, such as for malfunction or another condition requiring removal and immediate replacement.
Report this code when the operative record supports removal and replacement of the complete system; a procedure limited to a ventricular catheter, valve, or distal catheter calls for a different code. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 62258
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.25 · 46%
- Practice expense (office) RVU11.77 · 36%
- Malpractice RVU6.07 · 18%
313
Medicare services in 2024 · #3963 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.
62258 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Use 62230 for revision or replacement of a shunt or a component. This code is for exchange of the complete system.
No office rate
Use 62225 for ventricular catheter replacement or irrigation, not removal and replacement of the complete shunt system.
No office rate
Use 62223 when establishing a shunt, rather than exchanging an existing complete system.
Compare 62258 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $1105.94 |
| Beaumont | Office Unavailable | Facility $1055.46 |
| Brazoria | Office Unavailable | Facility $1061.17 |
| Dallas | Office Unavailable | Facility $1079.46 |
| Fort Worth | Office Unavailable | Facility $1078.16 |
| Galveston | Office Unavailable | Facility $1071.69 |
| Houston | Office Unavailable | Facility $1182.79 |
| Rest Of Texas | Office Unavailable | Facility $1065.52 |
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62258 billing questions
When is this code appropriate instead of 62230?
Use this code when the operation removes and replaces the complete shunt system. Code 62230 describes revision or replacement of a shunt or a component rather than complete system exchange.
How does this differ from 62256?
This code describes complete system removal with replacement during the operation. Code 62256 is for complete system removal without replacement.
Can a ventricular catheter replacement be reported with this code?
A procedure limited to ventricular catheter replacement or irrigation is distinct from complete system exchange and is described by 62225. The operative report should identify which components were removed and replaced.
What documentation supports complete system replacement?
Document removal of the existing complete shunt system and placement of the replacement system, including the components addressed and the clinical reason for exchange.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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.
6,93962252,26,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
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