CPT 62270
Global 000 ActiveDx lmbr spi pnxr
CPT 62270 Billing & Documentation Guide
CPT code 62270 (Dx lmbr spi pnxr) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.19, a non-facility practice expense RVU of 3.46, and a malpractice RVU of 0.29, a total non-facility RVU of 4.94 and facility RVU of 1.76. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $169.46, though rates vary from $144.01 to $215.96 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 62270, 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 62270 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 62270 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 62270
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.19 | 1.19 |
| Practice Expense RVU | 3.46 | 0.28 |
| Malpractice RVU | 0.29 | 0.29 |
| Total RVU | 4.94 | 1.76 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 62270
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 | $183.17 | $57.49 | $172.28 - $215.96 | 29 |
| Florida | $174.56 | $67.99 | $164.79 - $184.55 | 3 |
| Georgia | $161.65 | $60.32 | $154.38 - $168.92 | 2 |
| Illinois | $170.07 | $67.43 | $160.4 - $178.4 | 4 |
| Michigan | $161.9 | $62.16 | $156.2 - $167.6 | 2 |
| North Carolina | $153.76 | $54.66 | $153.76 - $153.76 | 1 |
| New York | $183.73 | $65.23 | $156.35 - $197.69 | 5 |
| Ohio | $155.02 | $58.05 | $155.02 - $155.02 | 1 |
| Pennsylvania | $163.66 | $59.62 | $154.99 - $172.32 | 2 |
| Texas | $162.74 | $58.17 | $153.91 - $170.68 | 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 62270
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 62270 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00635 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01935 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01936 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01937 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01938 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01939 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01940 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01941 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01942 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 62270
What does CPT code 62270 mean? +
CPT code 62270 represents: Dx lmbr spi pnxr. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 62270? +
The 2026 Medicare national average non-facility payment for CPT 62270 is $169.46. Rates range from $144.01 to $215.96 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 62270? +
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 62270? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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