Billing code 62368: Pump analysisMedicare rate & RVUs in Washington
Reports electronic analysis and adjustment of a programmable implanted pump delivering intrathecal or epidural medication, without a refill service.
Medicare pays $47.34–$52.16 for 62368 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 62368 covers
A clinician uses the pump’s programmer to interrogate an implanted device that delivers medication into the intrathecal or epidural space, review its status, and change programmed infusion settings. Pain medicine specialists may use this service when adjusting intrathecal analgesia for chronic pain; physiatrists or other treating clinicians may adjust intrathecal baclofen delivery for spasticity. It is commonly performed during an outpatient visit when symptoms, treatment response, or medication effects prompt a change to the pump program.
Report 62368 when electronic analysis results in an actual programming change and the service does not include pump refill and maintenance. Record the device and indication, findings from the interrogation, the prior and revised settings, and the clinical reason for the adjustment. If analysis is performed without a setting change, consider 62367. When refill and maintenance are part of the service, select from the 62369–62370 family rather than reporting this analysis service for the same work. The Medicare physician fee schedule assigns work and practice-expense values to 62368.
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 62368 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $47.34 | $29.40 |
| Seattle (King Cnty) | $52.16 | $31.26 |
How the 62368 rate is calculated
Each of 62368’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 · 62368
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.65Practice expense 0.67Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 62368
62368 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 62368
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$46.43
The facility rate would be $29.39 (+$17.04). In a facility, the facility bills its own costs separately.
62368 compared with similar codes
Compare codes
62368 vs 62367 vs 62369 vs 62370: national Medicare rates
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How to choose
- 62367Pump analysis
- Use 62367 when electronic analysis does not change the programmed settings; 62368 requires reprogramming.
- 62369Pump management
- This code is for a refill-and-maintenance service with reprogramming, rather than analysis and reprogramming without refill.
- 62370Pump refill
- This code is also in the refill-and-maintenance family; use 62368 when the encounter involves reprogramming without refill and maintenance.
62368 billing questions
How does 62368 differ from 62367?
62368 includes an actual change to the pump’s programmed settings. Use 62367 when the pump is analyzed but no reprogramming is performed.
Does 62368 include a pump refill?
No. It covers analysis with reprogramming, not refill and maintenance. When the service includes refill and maintenance, use the applicable code from the 62369–62370 family.
What documentation supports 62368?
Document the implanted pump and treatment indication, interrogation findings, settings before and after the adjustment, and the clinical reason for changing the program.
Can 62368 be reported with 62369 or 62370 for the same pump service?
Do not report 62368 separately for programming work included in a refill-and-maintenance service. Choose the code that represents the service actually performed.
What clinical situations commonly lead to reprogramming?
Examples include adjusting intrathecal analgesia for chronic pain or baclofen delivery for spasticity in response to symptoms, treatment response, or medication effects.
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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