CPT 62252 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Cerebrospinal Fluid (CSF) Shunt Procedures Surgical Procedures on the Skull, Meninges, and Brain |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 62252 |
National average reimbursement for CPT 62252 by major payers:
$112.63
$117.65
$126.51
$137.83
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 62252 | $397.00 | 1104933696 - WEST LAKES SURGERY CENTER LLC | 205345295 - (IA) WEST LAKES SURGERY CENTER, LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $27.70 | 1124526611 - KATHLEEN QUATRO | 350593390 - DEACONESS HOSPITAL INC | KY | Family Nurse Practitioner (363LF0000X) |
United | 62252 | $566.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $56.86 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | 62252 | $688.00 | 1902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE | 352599588 - (TX) HILL COUNTRY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $172.00 | 1508845942 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER WEST | 621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $351.00 | 1326549676 - CHATHAM ORTHOPAEDIC ASC, LLC, CHATHAM ORTHOPAEDIC SURGERY CENTER | 824075002 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $92.48 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 62252 | $290.00 | 1043271604 - NORTH FULLERTON SURGERY CENTER, LLC | 223849885 - (NJ) NORTH FULLERTON SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $300.00 | 1801220983 - THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY, LLC | 461416301 - (AZ) THE MINIMALLY INVASIVE SPINE SURGERY CENTER OF PARADISE VALLEY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $668.00 | 1184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC | 364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $1127.00 | 1316072234 - ARIA HEALTH SYSTEM, ARIA HEALTH FRANKFORD CAMPUS SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $574.00 | 1972869881 - ADVANCED SURGERY CENTER OF BETHESDA, LLC | 454376136 - (MD) ASC BETHESDA | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $103.00 | 1770151722 - SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA, LLC, ALLIANCE SPECIALTY SURGICAL CENTER | 863661396 - (FL) SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62252 | $200.00 | 1376194431 - ASCENT SURGERY CENTER LLC | 823347568 - (TX) ASCENT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 62252 vs. Other Surgical Procedures on the Skull, Meninges, and Brain Codes
The CPT 62252 code is part of the Cerebrospinal Fluid (CSF) Shunt Procedures services used for Surgical Procedures on the Skull, Meninges, and Brain. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 62252 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 62148-CPT | Low | Retr Bone Flap To Fix Skull, Incision And Retrieval Of Subcutaneous Cranial Bone Graft For Cranioplasty (List Separately In Addition To Code For Primary Procedure) |
| 62160-CPT | Moderate | Neuroendoscopy Add On, Neuroendoscopy Intracranial For Placement Or Replacement Of Ventricular Catheter And Attachment To Shunt System Or External Drainage List Separately In Addition To Code For Primary Procedure |
| 62230-CPT | High | Replacement Or Revision Of Csf, Replacement Or Revision Of Csf Shunt Obstructed Valve Ordistal Catheter In Shunt System Replacement Or Revision Of Csf Shunt Obstructed Valve Or |
| 62252-CPT | Low | Adjust Shunt For Spinal Fluid, Surgery To Adjust Shunt (Passageway) Used To Drain Excess Cerebrospinal Fluid From The Brain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 62252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 62252 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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