$31.57
Use 62367 when electronic analysis does not change the programmed settings; 62368 requires reprogramming.
On this page
CMS RVU26D · Effective 2026-10-01
62368 Pump analysis Medicare reimbursement rates in Wisconsin
Reports electronic analysis and adjustment of a programmable implanted pump delivering intrathecal or epidural medication, without a refill service. Compare 62368 office and facility rates across CMS payment localities in Wisconsin.
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 62368 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$43.87
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$27.55
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Implanted pump services
About 62368: Implanted infusion pump analysis with reprogramming
Reports electronic analysis and adjustment of a programmable implanted pump delivering intrathecal or epidural medication, without a refill service.
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.
Where the value comes from
- Work RVU0.65 · 47%
- Practice expense (office) RVU0.67 · 48%
- Malpractice RVU0.07 · 5%
26.4K
Medicare services in 2024 · #1028 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.
62368 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$92.51
This code is for a refill-and-maintenance service with reprogramming, rather than analysis and reprogramming without refill.
$92.61
This code is also in the refill-and-maintenance family; use 62368 when the encounter involves reprogramming without refill and maintenance.
Compare 62368 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
$43.87
Facility
$27.55
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 62368 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,984
- Code
- 62368
- Physician work
- 0.65
- Practice expense
- 0.67
- Malpractice
- 0.07
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.65 | × 1.000 | 0.6500 |
| Practice expense | 0.67 | × 0.958 | 0.6419 |
| Malpractice | 0.07 | × 0.308 | 0.0216 |
| Total RVUs | 1.3134 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$43.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.65 | 1 |
| Practice expense | 0.67 | 0.958 |
| Malpractice | 0.07 | 0.308 |
(0.65 × 1 + 0.67 × 0.958 + 0.07 × 0.308) × $33.4009 = $43.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.65 | 1 |
| Practice expense | 0.16 | 0.958 |
| Malpractice | 0.07 | 0.308 |
(0.65 × 1 + 0.16 × 0.958 + 0.07 × 0.308) × $33.4009 = $27.55
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
6,98162362,,Implant spine infusion pump,A,,5.46,4.41,NA,4.41,,1.26,11.13,11.13,0,010,0.10,0.80,0.10,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98262365,,Remove spine infusion device,A,,3.83,4.05,NA,4.05,,0.98,8.86,8.86,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98362367,,Analyze spine infus pump,A,,0.47,0.48,,0.12,,0.05,1.00,0.64,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98462368,,Analyze sp inf pump w/reprog,A,,0.65,0.67,,0.16,,0.07,1.39,0.88,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98562369,,Anal sp inf pmp w/reprg&fill,A,,0.65,2.19,,0.17,,0.07,2.91,0.89,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98662370,,Anl sp inf pmp w/mdreprg&fil,A,,0.88,1.95,,0.22,,0.08,2.91,1.18,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,98762380,,Ndsc dcmprn 1 ntrspc lumbar,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.11,0.76,0.13,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,