How much does Medicare pay for CPT 62252?

Medicare allowed an average of $67.99 per service and paid $52.17 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $384.81, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 62252?

Reprogramming of cerebrospinal fluid shunt. It was billed 3,538 times to 2,357 Medicare beneficiaries by 101 providers in 2024.

Does 62252 pay differently in an office than a hospital?

Yes. The allowed amount averaged $76.58 in an office setting and $43.48 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 62252 most?

Neurosurgery, with 1,381 services from 36 clinicians. Next are Nurse Practitioner, Neurology, Physician Assistant.

CPT 62252

Reprogramming of cerebrospinal fluid shunt

$67.99Medicare-allowed amount per service, averaged across 3,538 services

Providers submitted

$384.81

Asking price, not received

Medicare allowed

$67.99

The fee schedule figure

Medicare paid

$52.17

Balance is patient coinsurance

Providers submitted an average of $384.81 for this code and Medicare allowed $67.99 — 5.7× 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 $52.17 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $76.58
Hospital / facility: $43.48

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,620 services were billed in an office setting and 918 in a facility.

Services: 3,538
Beneficiaries: 2,357
Providers billing it: 101
Total allowed: $240,549

What Medicare pays for CPT 62252

Across 3,538 services billed by 101 providers to 2,357 beneficiaries, Medicare allowed an average of $67.99 per service. That is 1.5 services per beneficiary, so this is a code patients typically receive more than once. 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 62252

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	1,381	862	$72.68	36
Nurse Practitioner	1,226	871	$59.38	41
Neurology	445	288	$83.98	7
Physician Assistant	404	294	$57.65	15
Physical Medicine and Rehabilitation	66	30	$84.98	1
Certified Clinical Nurse Specialist	16	12	$69.38	1

62252 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	716	$75.90	$54.33	15
Texas	351	$77.41	$58.11	7
Virginia	311	$44.86	$36.17	3
Maryland	297	$63.29	$46.16	3
Massachusetts	238	$49.93	$35.57	8
New York	232	$94.85	$61.81	7
Ohio	214	$58.34	$48.18	9
North Carolina	160	$62.45	$51.91	6
Florida	154	$76.27	$59.54	5
Arizona	120	$75.87	$61.81	3
Connecticut	110	$80.69	$57.60	4
South Carolina	69	$74.44	$59.46	3
Minnesota	67	$71.01	$56.73	1
Indiana	57	$69.21	$55.56	4
Washington	51	$40.97	$31.25	2
Missouri	44	$73.66	$50.08	2
Pennsylvania	44	$74.45	$55.70	3
Tennessee	43	$71.81	$64.10	2
Nevada	38	$70.53	$54.27	2
Georgia	37	$86.50	$58.46	2
North Dakota	33	$34.53	$29.45	2
Wyoming	31	$37.41	$28.41	1
Michigan	27	$42.26	$29.17	1
Mississippi	27	$63.96	$52.84	2
Kentucky	23	$41.14	$30.51	1
Delaware	16	$82.23	$67.32	1
Oklahoma	14	$63.73	$55.53	1
Iowa	14	$33.15	$23.02	1

Related codes

62264Removal of spinal canal scar tissue$360.21
62270Removal of cerebrospinal fluid$92.02
62284Injection of contrast for imaging of lower spinal canal$81.56
62290Injection of contrast for imaging of each level of lower spine$192.84
62223Creation of brain fluid drainage shunt$693.11

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.