How much does Medicare pay for CPT 62369?

Medicare allowed an average of $78.93 per service and paid $58.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $439.73, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 62369?

Electronic analysis reprogramming and refill of spinal canal drug infusion pump. It was billed 14,899 times to 5,798 Medicare beneficiaries by 190 providers in 2024.

Does 62369 pay differently in an office than a hospital?

Yes. The allowed amount averaged $81.71 in an office setting and $32.96 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 62369 most?

Nurse Practitioner, with 2,675 services from 44 clinicians. Next are Interventional Pain Management, Anesthesiology, Physical Medicine and Rehabilitation.

CPT 62369

Electronic analysis reprogramming and refill of spinal canal drug infusion pump

$78.93Medicare-allowed amount per service, averaged across 14,899 services

Providers submitted

$439.73

Asking price, not received

Medicare allowed

$78.93

The fee schedule figure

Medicare paid

$58.66

Balance is patient coinsurance

Providers submitted an average of $439.73 for this code and Medicare allowed $78.93 — 5.6× 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 $58.66 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $81.71
Hospital / facility: $32.96

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. 14,052 services were billed in an office setting and 847 in a facility.

Services: 14,899
Beneficiaries: 5,798
Providers billing it: 190
Total allowed: $1,175,978

What Medicare pays for CPT 62369

Across 14,899 services billed by 190 providers to 5,798 beneficiaries, Medicare allowed an average of $78.93 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 62369

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	2,675	1,195	$68.46	44
Interventional Pain Management	2,639	919	$82.17	30
Anesthesiology	2,185	733	$79.28	24
Physical Medicine and Rehabilitation	1,917	599	$77.36	21
Pain Management	1,820	865	$83.94	28
Physician Assistant	1,239	645	$76.71	21
Internal Medicine	849	263	$95.75	1
Family Practice	404	177	$84.12	4
Neurosurgery	383	116	$80.40	6
Neurology	315	103	$80.67	5
Diagnostic Radiology	222	83	$81.36	1
Otolaryngology	123	40	$73.36	1
Ambulatory Surgical Center	62	14	$62.19	1
Emergency Medicine	23	13	$73.38	1
Pediatric Medicine	22	16	$32.35	1

62369 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
Minnesota	2,410	$83.19	$61.86	27
Texas	1,067	$81.75	$64.73	17
Missouri	890	$77.05	$68.16	4
Michigan	871	$75.57	$58.15	10
Indiana	868	$76.80	$62.98	10
Kentucky	807	$72.57	$64.98	5
Florida	750	$82.83	$67.76	11
Nevada	665	$83.67	$63.80	6
Arkansas	576	$74.47	$68.26	8
Oklahoma	527	$78.88	$68.03	3
Louisiana	504	$81.06	$65.65	12
New York	496	$84.52	$54.87	5
Arizona	451	$89.84	$69.13	3
California	436	$94.35	$64.15	10
South Carolina	406	$79.55	$67.20	3
Wisconsin	286	$64.34	$51.74	4
Ohio	279	$71.84	$56.27	6
Massachusetts	276	$96.13	$65.18	3
Pennsylvania	241	$81.88	$63.57	4
Illinois	228	$56.79	$44.98	7
Alabama	214	$72.72	$68.97	3
Washington	197	$59.74	$44.14	4
Mississippi	187	$27.09	$22.70	1
New Jersey	186	$98.61	$65.35	1
Connecticut	165	$68.40	$48.05	2
Maryland	142	$47.31	$36.22	2
Kansas	124	$81.21	$64.05	1
Alaska	121	$106.26	$68.21	2
Utah	114	$81.76	$69.83	3
North Carolina	104	$76.43	$63.47	4
South Dakota	89	$66.87	$51.92	3
Georgia	84	$87.03	$61.39	2
District of Columbia	63	$61.77	$35.12	2
Oregon	39	$94.56	$67.19	1
Idaho	36	$64.07	$60.43	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
62368Electronic analysis and reprogramming of spinal canal drug infusion pu$39.38
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.