CPT 62252
Global XXX ActiveCsf shunt reprogram
CPT 62252 Billing & Documentation Guide
CPT code 62252 (Csf shunt reprogram) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.72, a non-facility practice expense RVU of 2.11, and a malpractice RVU of 0.28, a total non-facility RVU of 3.11 and facility RVU of 3.11. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $106.1, though rates vary from $89.4 to $133.33 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 62252, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 62252 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 62252 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 62252
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.72 | 0.72 |
| Practice Expense RVU | 2.11 | 2.11 |
| Malpractice RVU | 0.28 | 0.28 |
| Total RVU | 3.11 | 3.11 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 62252
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $113.37 | $113.37 | $106.71 - $133.33 | 29 |
| Florida | $112.97 | $112.97 | $105.48 - $121.07 | 3 |
| Georgia | $102.51 | $102.51 | $98.06 - $106.96 | 2 |
| Illinois | $110.1 | $110.1 | $103.01 - $116.51 | 4 |
| Michigan | $103.39 | $103.39 | $98.95 - $107.83 | 2 |
| North Carolina | $95.78 | $95.78 | $95.78 - $95.78 | 1 |
| New York | $116.53 | $116.53 | $97.58 - $126.75 | 5 |
| Ohio | $97.82 | $97.82 | $97.82 - $97.82 | 1 |
| Pennsylvania | $103.29 | $103.29 | $97.58 - $109 | 2 |
| Texas | $102.25 | $102.25 | $96.87 - $107.09 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 62252
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 62252 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 62252
What does CPT code 62252 mean? +
CPT code 62252 represents: Csf shunt reprogram. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of XXX.
What is the Medicare reimbursement for CPT 62252? +
The 2026 Medicare national average non-facility payment for CPT 62252 is $106.1. Rates range from $89.4 to $133.33 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 62252? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 62252? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 17, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team