How much does Medicare pay for CPT 62368?

Medicare allowed an average of $39.38 per service and paid $30.08 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $208.79, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 62368?

Electronic analysis and reprogramming of spinal canal drug infusion pump. It was billed 12,626 times to 4,840 Medicare beneficiaries by 238 providers in 2024.

Does 62368 pay differently in an office than a hospital?

Yes. The allowed amount averaged $40.03 in an office setting and $30.96 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 62368 most?

Anesthesiology, with 3,080 services from 47 clinicians. Next are Pain Management, Nurse Practitioner, Interventional Pain Management.

CPT 62368

Electronic analysis and reprogramming of spinal canal drug infusion pump

$39.38Medicare-allowed amount per service, averaged across 12,626 services

Providers submitted

$208.79

Asking price, not received

Medicare allowed

$39.38

The fee schedule figure

Medicare paid

$30.08

Balance is patient coinsurance

Providers submitted an average of $208.79 for this code and Medicare allowed $39.38 — 5.3× 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 $30.08 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $40.03
Hospital / facility: $30.96

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. 11,722 services were billed in an office setting and 904 in a facility.

Services: 12,626
Beneficiaries: 4,840
Providers billing it: 238
Total allowed: $497,212

What Medicare pays for CPT 62368

Across 12,626 services billed by 238 providers to 4,840 beneficiaries, Medicare allowed an average of $39.38 per service. That is 2.6 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 62368

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	3,080	1,104	$42.41	47
Pain Management	2,213	814	$40.16	43
Nurse Practitioner	2,142	912	$32.69	50
Interventional Pain Management	1,603	620	$42.51	31
Physician Assistant	1,117	460	$34.11	28
Physical Medicine and Rehabilitation	819	308	$42.51	16
Neurosurgery	525	174	$40.60	7
Family Practice	298	108	$38.46	4
Internal Medicine	289	110	$44.34	2
Neurology	246	91	$35.45	4
Diagnostic Radiology	175	64	$42.25	2
Hospice and Palliative Care	51	26	$42.35	1
Emergency Medicine	31	19	$42.35	1
Psychiatry	21	14	$49.67	1
Ambulatory Surgical Center	16	16	$21.75	1

62368 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	2,186	$43.79	$32.35	22
Texas	1,349	$40.21	$31.56	23
Indiana	1,018	$36.57	$29.35	20
Florida	799	$40.78	$31.59	24
Arizona	727	$38.26	$32.71	9
Kentucky	630	$38.04	$31.07	12
Minnesota	592	$40.52	$30.81	13
Ohio	547	$36.76	$30.23	11
Missouri	488	$34.07	$27.70	6
New York	458	$43.01	$33.62	6
Arkansas	403	$37.79	$32.81	4
Oklahoma	362	$39.23	$33.37	8
Idaho	361	$29.43	$24.56	9
South Carolina	343	$35.76	$33.86	5
Pennsylvania	252	$45.62	$33.56	7
South Dakota	194	$40.83	$32.35	2
Nebraska	182	$33.35	$33.77	4
Kansas	166	$36.55	$29.94	7
Nevada	157	$39.22	$30.69	5
Tennessee	157	$37.01	$30.19	5
Alaska	137	$46.97	$27.29	2
Illinois	128	$44.91	$29.67	5
Virginia	121	$42.49	$34.42	4
Michigan	121	$39.12	$31.94	3
Massachusetts	113	$39.33	$30.01	4
Georgia	99	$42.13	$33.85	2
Oregon	97	$39.22	$30.27	2
Wisconsin	69	$29.68	$24.59	3
Louisiana	69	$38.05	$31.87	2
Washington	69	$28.39	$23.70	2
Montana	57	$29.82	$21.55	1
Connecticut	49	$42.14	$30.60	2
West Virginia	44	$34.44	$29.50	2
Mississippi	43	$26.74	$22.60	1
New Jersey	39	$46.55	$32.64	1

Related codes

62323Injection of substance into lower spine canal$200.33
62321Injection of substance into middle or upper spine canal$215.08
62370Electronic analysis reprogramming and refill of spinal canal drug infu$76.65
62328Removal of spinal fluid$81.96
62369Electronic analysis reprogramming and refill of spinal canal drug infu$78.93
62322Injection of substance into lower spine canal$84.43
62367Electronic analysis of spinal canal drug infusion pump$28.62
62362Insertion of programmable spinal canal drug infusion pump$4222.97
62324Insertion of tube and injection of substance into middle or upper spin$90.95
62304X-ray of lower spinal canal$156.91
62350Insertion, revision, or repositioning of spinal canal tube for medicat$922.79

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.