How much does Medicare pay for CPT 62223?

Medicare allowed an average of $693.11 per service and paid $552.11 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $5520.32, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 62223?

Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus. It was billed 1,224 times to 1,195 Medicare beneficiaries by 67 providers in 2024.

Which specialty bills 62223 most?

Neurosurgery, with 824 services from 41 clinicians. Next are General Surgery, Physician Assistant, Critical Care (Intensivists).

CPT 62223

Creation of brain fluid drainage shunt, ventriculo-peritoneal, -pleural, other terminus

$693.11Medicare-allowed amount per service, averaged across 1,224 services

Providers submitted

$5520.32

Asking price, not received

Medicare allowed

$693.11

The fee schedule figure

Medicare paid

$552.11

Balance is patient coinsurance

Providers submitted an average of $5520.32 for this code and Medicare allowed $693.11 — 8.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $552.11 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,224
Beneficiaries: 1,195
Providers billing it: 67
Total allowed: $848,367

What Medicare pays for CPT 62223

Across 1,224 services billed by 67 providers to 1,195 beneficiaries, Medicare allowed an average of $693.11 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 62223

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	824	798	$748.81	41
General Surgery	269	268	$664.55	17
Physician Assistant	44	44	$127.94	3
Critical Care (Intensivists)	24	24	$688.67	2
General Practice	22	22	$621.96	1
Nurse Practitioner	19	17	$73.00	1
Neurology	11	11	$802.38	1
Colorectal Surgery (Proctology)	11	11	$594.35	1

62223 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	293	$644.25	$432.66	14
Ohio	101	$597.47	$445.61	6
Maryland	89	$735.61	$479.45	3
New York	87	$843.71	$515.78	6
Massachusetts	75	$702.95	$412.52	5
Arizona	75	$582.83	$423.11	3
Minnesota	70	$676.44	$477.22	3
Florida	66	$899.66	$592.13	5
Connecticut	55	$794.05	$482.56	1
Texas	53	$772.44	$464.70	2
Virginia	43	$875.49	$627.88	3
Tennessee	41	$449.04	$294.07	3
North Carolina	38	$698.37	$514.62	2
Indiana	35	$461.49	$321.68	3
Pennsylvania	26	$874.06	$576.64	2
Illinois	16	$636.57	$481.81	1
Louisiana	14	$836.01	$654.54	1
Iowa	13	$565.46	$435.25	1
Nevada	12	$614.12	$487.47	1
Kansas	11	$594.35	$397.78	1
Washington	11	$727.16	$303.80	1

Related codes

62264Removal of spinal canal scar tissue$360.21
62270Removal of cerebrospinal fluid$92.02
62252Reprogramming of cerebrospinal fluid shunt$67.99
62284Injection of contrast for imaging of lower spinal canal$81.56
62290Injection of contrast for imaging of each level of lower spine$192.84

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.