CPT code 62362 reports the implantation or replacement of a programmable pump for intrathecal or epidural drug infusion, including preparation of the pump. Procedure code 62362 delivers continuous medication to the spinal canal for chronic intractable pain and intractable spasticity.
The 62362 CPT code is the highest-dollar procedure in interventional pain management and the most documentation-heavy. Most denials trace to four causes, including a missing trial record, no prior authorization, billing pump removal with a replacement, and incomplete device documentation. Practices that implant pumps rely on dedicated pain management billing services to protect these high-value claims.
What Is the Description of CPT Code 62362?
CPT code 62362 is defined by the AMA as the implantation or replacement of a device for intrathecal or epidural drug infusion, specifically a programmable pump, including preparation of the pump, with or without programming. The pump sits under the skin and delivers medication through a catheter to the spinal canal.
The 62362 CPT code supports continuous infusion of anesthetics, antispasmodics, opioids, and other agents. It treats severe chronic pain and intractable spasticity that has failed less invasive care. Targeted spinal delivery achieves pain control with a fraction of the oral dose.
What Procedure Does CPT 62362 Cover?
CPT 62362 covers placing or replacing the programmable pump and preparing it for use. The code includes preparation, and it may include initial programming. The catheter that carries the drug is a separate procedure.
The word replacement in the descriptor matters for procedure code 62362. Removing an old pump and implanting a new one is reported with 62362 alone, because the removal is built into the replacement. The pump is programmable, so the dose can be adjusted without further surgery.
How Does CPT 62362 Fit the Intrathecal Pump Code Family?
CPT 62362 is the programmable pump code within a larger intrathecal drug delivery family. The following table maps the related codes:
| CPT Code | Description |
|---|---|
| 62360 | Implantation or replacement of a subcutaneous reservoir |
| 62361 | Implantation or replacement of a non-programmable pump |
| 62362 | Implantation or replacement of a programmable pump |
| 62365 | Removal of a previously implanted reservoir or pump |
| 62350, 62351 | Tunneled catheter implantation, without or with laminectomy |
| 62367 to 62370 | Electronic analysis and reprogramming of the pump |
| 95990, 95991 | Refilling and maintenance of the pump |
Code selection depends on the device and the work performed. The 62362 CPT code applies to a programmable pump. A non-programmable pump uses 62361, and a reservoir uses 62360. The analysis and refill codes generate recurring revenue across the life of the device. The full set of interventional codes is mapped in the pain management CPT code guide.
How Are the Pump and Catheter Coded Together?
CPT 62362 reports the pump, while a separate code reports the tunneled catheter. For a new system, the claim includes 62362 for the pump and 62350 or 62351 for the catheter.
Code 62350 reports a tunneled catheter without laminectomy, and 62351 reports one with laminectomy. The two procedures are distinct, so a new implant bills both. In the facility setting, the encounter maps to the pump implantation payment group, so the catheter does not add a separate facility payment.
How Is a Pump Replacement Coded?
CPT 62362 is reported alone for a pump replacement. The NCCI edits bundle 62365, the pump removal code, into 62362 when the old pump is removed, and a new one is implanted in the same session.
Billing 62365 with the 62362 CPT code for a routine replacement is a frequent error that denies. The removal is part of the replacement value. An override applies only for a separate encounter or a distinct anatomic site, supported by documentation.
What Are the Modifiers for CPT Code 62362?
Procedure code 62362 carries a global period, so the staged and return-to-surgery modifiers apply during recovery. Correct global-period coding protects later claims.
Modifier 58: Staged or Related Procedure
Modifier 58 reports a planned, staged procedure during the global period of CPT 62362. A permanent pump implant that follows a planned trial within the global window uses modifier 58 when applicable.
Modifier 78: Unplanned Return to the Operating Room
Modifier 78 reports an unplanned return to the operating room for a related complication during the global period. A catheter revision for a flow problem after a 62362 implant uses modifier 78.
Modifier 79: Unrelated Procedure During the Global Period
Modifier 79 reports an unrelated procedure by the same physician during the global period of the 62362 CPT code. The diagnosis must show that the later service is unrelated to the pump implant.
Modifiers 22, 80, and 82
Modifier 22 reports significantly increased complexity in documentation. Modifiers 80 and 82 report an assistant surgeon when a second provider assists with the implant.
Which Documents Are Required for CPT Code 62362?
Documentation for CPT 62362 must establish the trial result, the failed conservative care, the psychological clearance, and the device detail. A missing trial record is the leading cause of denial.
Required Documentation Checklist:
- A successful intrathecal trial, with the percentage of pain relief recorded
- Failure of at least twelve weeks of conservative therapy targeting the region
- A psychological evaluation supporting candidacy for an implanted pump
- Confirmation that the patient is not opioid naive, per payer policy
- Prior authorization approval on file before the date of service
- Device make, model, and serial number, with the manufacturer’s invoice
- Operative note detailing pump placement, catheter placement, and programming
What Is the Cost of CPT Code 62362?
The cost of CPT code 62362 splits into the physician professional fee and the facility payment that covers the high-cost pump device. The device drives the total cost, and the facility carries it.
RVUs and Medicare Payment
The 2026 work RVU for CPT 62362 is 5.46, sourced from the CMS Physician Fee Schedule file RVU26A. The code carries a 10-day global period. The CY2026 conversion factor is $33.4009 for non-qualifying clinicians and $33.5675 for qualifying APM participants.
Medicare converts total RVUs to dollars with this formula:
Payment = [(Work RVU × Work GPCI) + (PE RVU × PE GPCI) + (MP RVU × MP GPCI)] × Conversion Factor
The physician professional allowance for procedure code 62362 runs in the low hundreds of dollars before locality adjustment, because most pump procedures occur in a facility. Confirm the exact facility RVUs in the current MPFS lookup, since the setting changes the practice expense value when it comes to the CPT codes.
The Device Cost and Facility Payment
The programmable pump is a high-cost implant, and the facility carries that cost, not the physician’s claim. In the hospital outpatient setting, CPT 62362 maps to a comprehensive payment group that packages the device.
When 62362 and the catheter are billed together in a facility, the encounter maps to the pump implantation payment group, so the catheter and device are packaged into one comprehensive payment. In an ASC, the FB or FC modifier reports a device furnished at no cost or with credit. The physician bills only the professional service.
Downstream Pump Revenue
CPT 62362 begins a long revenue relationship, not a one-time claim. The implanted pump requires ongoing refills and periodic analysis.
Refilling and maintenance use 95990 and 95991, and electronic analysis and reprogramming use 62367 through 62370. These recurring services generate predictable revenue across the device life. Capturing every refill and reprogramming visit protects the full value of the 62362 CPT code program.
Commercial Payer Reimbursement
Commercial plans reimburse 62362 CPT code claims at facility rates that vary by contract, and nearly all require prior authorization. Workers’ compensation and auto carriers cover pumps for injury-related intractable pain under state fee schedules.
Prior authorization is effectively mandatory for an implanted pump. Payers require the trial result, the conservative care history, and the psychological evaluation before approval. Submitting without authorization guarantees a denial on this high-dollar code.
What Are Example Clinical Scenarios for CPT Code 62362?
CPT code 62362 applies when a programmable pump is implanted or replaced for intractable pain. The following three scenarios show correct pump, catheter, and replacement coding.
Scenario 1: New Pump Implant After a Successful Trial
ICD-10: M96.1 (Postlaminectomy syndrome)
A patient with failed back surgery syndrome completes a successful intrathecal trial with more than 50% pain relief. The surgeon implants a programmable pump and a tunneled catheter. The claim reports CPT 62362 for the pump and 62350 for the catheter, linked to M96.1. The trial result and psychological clearance are documented.
Scenario 2: Pump Replacement for End of Battery Life
ICD-10: G89.4 (Chronic pain syndrome)
A patient returns for a planned pump replacement as the battery nears the end of its life. The surgeon removes the old pump and implants a new programmable pump in the same session. The claim reports CPT 62362 alone, not 62362 plus 62365. The removal is bundled into the replacement.
Scenario 3: Pump Implant for Intractable Cancer Pain
ICD-10: G89.3 (Neoplasm-related pain)
A patient with intractable cancer pain and a short oral medication tolerance receives a programmable pump and catheter. The surgeon documents the trial, the life expectancy, and the failed systemic therapy. The claim reports CPT 62362 with 62351, linked to G89.3, with prior authorization on file.
What Are the 62362 Rules to Ensure Successful Reimbursement?
Successful reimbursement for CPT code 62362 follows the trial pathway, the bundling rules, the global period, and the device documentation. Meeting these rules protects the highest-value claim in the pain practice.
The Trial-to-Permanent Medical Necessity Pathway
CPT 62362 is covered only after a documented pathway that proves the implant is necessary. Payers require a successful intrathecal trial before the permanent pump.
The pathway includes a trial with at least 50% pain relief, failure of at least twelve weeks of conservative therapy, a psychological evaluation, and confirmation that the patient is not opioid naive. The following table maps common pain ICD-10 codes that support a 62362 implant:
| ICD-10 Code | Description |
|---|---|
| G89.4 | Chronic pain syndrome |
| G89.3 | Neoplasm-related pain |
| G89.0 | Central pain syndrome |
| M96.1 | Postlaminectomy syndrome |
| G89.29 | Other chronic pain |
Intractable spasticity from multiple sclerosis, cerebral palsy, or spinal cord injury also supports a pump, coded with the relevant neurological diagnosis. The documentation must connect the diagnosis to the failed conservative care and the trial result.
Replacement and Removal Bundling Rules
CPT 62362 absorbs the pump removal code on a replacement. The NCCI edits bundle 62365 into 62362, so a routine replacement reports only the implant code.
Catheter codes follow a parallel rule. When a catheter is replaced, 62350 and 62351 bundle into 62355 for catheter removal, with an override only for a separate encounter or site. Reporting a removal code alongside a replacement is a predictable denial of the 62362 CPT code.
Global Period and Post-Operative Billing
CPT 62362 carries a 10-day global period. Routine post-operative visits within those 10 days are part of the surgical package and are not billed separately.
A staged or planned related procedure in the global window uses modifier 58. An unplanned return to the operating room uses modifier 78. An unrelated service uses modifier 79. An evaluation unrelated to the implant during the global period uses modifier 24 on the E/M.
Top Denial Reasons for 62362 and Quick Remedies
Four denial patterns account for most rejected CPT 62362 claims. Each has a documentation or claim-build fix applied before submission through structured medical billing services.
- No documented trial. Record the intrathecal trial and the percentage of pain relief before billing the permanent implant.
- Missing prior authorization. Secure authorization with the trial result, conservative care history, and psychological evaluation on file.
- Removal billed with a replacement. Report 62362 alone for a routine replacement; do not add 62365.
- Incomplete device documentation. Capture the device make, model, serial number, and invoice for the implant.
Frequently Asked Questions About CPT Code 62362
What is CPT Code 62362 Used For?
CPT code 62362 reports the implantation or replacement of a programmable intrathecal or epidural drug pump, used to deliver continuous medication for chronic intractable pain and spasticity.
Is the Catheter Included in CPT 62362?
No. CPT 62362 reports the pump only. The tunneled catheter is reported separately with 62350 or 62351, so a new system is billed with both the pump code and the catheter code.
How Do You Code a Pump Replacement with 62362?
A routine pump replacement is reported with CPT 62362 alone. The NCCI edits bundle the pump removal code 62365 into 62362, because the descriptor includes replacement.
What Is the Global Period for CPT 62362?
CPT 62362 carries a 10-day global period. Routine post-operative care within those 10 days is part of the surgical package and is not billed separately.
What Documentation Does Medicare Require for 62362?
Medicare and most payers require a successful intrathecal trial, failure of conservative therapy, a psychological evaluation, prior authorization, and complete device documentation.
Who Pays for the Intrathecal Pump Device?
The facility carries the high-cost pump device through its comprehensive payment group. The physician bills only the professional service for CPT 62362, not the device.
