Billing code 62273: Epidural blood patchMedicare rate & RVUs in Texas
An epidural blood patch places blood or clot in the epidural space to seal a cerebrospinal fluid leak, commonly after a dural puncture.
Medicare pays $162.98–$176.86 for 62273 in the office in Texas, from Beaumont to Austin. 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 62273 covers
An epidural blood patch uses blood, typically the patient’s own, placed into the epidural space to seal a cerebrospinal fluid leak. Anesthesiologists and pain physicians commonly perform it for a post-dural puncture headache after spinal anesthesia, an epidural procedure, or lumbar puncture. The procedure may take place in a hospital, ambulatory facility, or office equipped for neuraxial procedures.
Report 62273 for the patch procedure, rather than for a diagnostic spinal puncture or an epidural injection intended to treat spinal pain. Documentation should identify the leak-related indication, the epidural approach, and the patch performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same 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 is restricted, and co-surgeons and team surgery are not permitted.
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 62273 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$162.98 to $176.86
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $176.86 | $103.00 |
| Beaumont | $162.98 | $99.45 |
| Brazoria | $170.18 | $101.00 |
| Dallas | $171.27 | $101.74 |
| Fort Worth | $170.41 | $101.58 |
| Galveston | $170.71 | $101.39 |
| Houston | $174.55 | $105.23 |
| Rest Of Texas | $166.50 | $100.25 |
How the 62273 rate is calculated
Each of 62273’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 · 62273
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.10Practice expense 2.84Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 62273
The CMS indicators that decide how 62273 is paid alongside other services.
CMS payment indicators · 62273
Epidural blood patch
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
62273 without 51 · national office
$172.01
Epidural blood patch
62273-51 · Second procedure: 50%
$86.01
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
62273 compared with similar codes
Compare codes
62273 vs 62270 vs 62272 vs 62323: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 62270Lumbar puncture
- 62270 is a diagnostic lumbar puncture to obtain cerebrospinal fluid. Choose 62273 when blood or clot is placed in the epidural space to seal a leak.
- 62272Therapeutic lumbar puncture
- 62272 describes therapeutic spinal puncture for cerebrospinal fluid drainage. It does not describe an epidural blood patch.
- 62323Lumbar epidural injection
- 62323 is an epidural injection for medication treatment of spinal pain, not a blood or clot patch for a cerebrospinal fluid leak.
62273 billing questions
When should 62273 be chosen over a diagnostic lumbar puncture?
Use 62273 for an epidural blood or clot patch intended to seal a cerebrospinal fluid leak. A diagnostic lumbar puncture obtains cerebrospinal fluid for evaluation; it is not the patch treatment.
Is the blood draw separately reported as part of the patch?
The patch service is the epidural placement of blood or clot. Documentation should support the patch performed; do not report the blood volume as additional units of 62273.
Can modifier 50 be used for a bilateral blood patch?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or surgical team be reported for 62273?
Assistant-at-surgery payment is restricted. CMS also does not permit co-surgeons or team surgery 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 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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