Summary & Overview
CPT 62362: Implantation or Replacement of Programmable Intrathecal/Epidural Pump
CPT 62362 denotes the implantation or replacement of a programmable intrathecal or epidural drug infusion pump and includes pump preparation and optional programming. This procedure is clinically significant for managing chronic pain, spasticity, and certain neurologic conditions by delivering targeted medication directly to the spinal canal. Nationally, the code is relevant to hospital-based anesthesiology services and carries implications for utilization, device management, and perioperative care pathways.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the procedure and its clinical context, comparisons to closely related CPT codes for non-programmable pumps and reservoir devices, and highlights of common billing considerations. The publication outlines typical sites of service and service line context, common ICD-10 diagnoses associated with pump-related encounters, and operational notes such as commonly applied modifiers and related service codes. Where input data is incomplete, this summary notes missing elements explicitly.
This piece is intended to inform coding, billing, and clinical stakeholders about the scope and billing context of CPT 62362, offering clarity on what the code represents, associated procedural bundles, and the payer landscape that commonly covers the service.
CPT Code Overview
CPT 62362 describes the implantation or replacement of a programmable pump for intrathecal or epidural drug infusion, and includes preparation of the pump, with or without programming. This procedure falls under the Anesthesiology service type and is commonly performed in an Inpatient Hospital (POS 21) setting. The code covers placement or replacement of a device designed to deliver medications directly into the intrathecal or epidural space, where a programmable pump allows adjustment of infusion parameters as needed.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with chronic spasticity and focal neuropathic pain previously managed with systemically administered medications presents with recurrent pump malfunction and drug leakage. The patient is admitted to the inpatient hospital for operative management. The anesthesiology pain service performs implantation of a programmable intrathecal pump to deliver continuous targeted medication. The clinical workflow includes preoperative evaluation and optimization, device preparation and programming in the operating room, intraoperative implant and catheter placement, device testing, sterile dressing and recovery in the post-anesthesia care unit, and inpatient monitoring for hemodynamic stability, neurologic status, and wound complications prior to discharge.
Coding Specifications
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Modifier
59— Distinct Procedural ServiceUse when the implantation or replacement procedure is distinct and separate from other services performed on the same date that are not normally reported together.
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Modifier
51— Multiple ProceduresUse when multiple procedures are performed at the same operative session; list the primary service first and append
51to lesser-valued procedures according to payer rules. -
Associated provider taxonomies and specialties:
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology |
208VP0000X | Pain Medicine Physician |
207XS0117X | Spinal Cord Injury Medicine Physician |
Related Diagnoses
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T85.618A— Mechanical complication of other specified internal prosthetic devices, implants and grafts, initial encounterClinical relevance: Mechanical failure of an implanted intrathecal pump or its components can necessitate replacement or revision procedures such as implantation of a programmable pump (
62362). -
T85.630A— Leakage of internal prosthetic device or implant, initial encounterClinical relevance: Leakage from an implanted infusion device may require operative intervention, including replacement with a programmable pump to restore safe intrathecal drug delivery.
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G80.1— Spastic diplegic cerebral palsy (NOS)Clinical relevance: Spastic diplegic cerebral palsy can be an indication for intrathecal baclofen infusion via implanted pump therapy to manage severe spasticity; implantation of a programmable pump (
62362) is a treatment option for long-term targeted therapy.
Related CPT Codes
| CPT Code | Description | Relationship to 62362 |
|---|---|---|
62360 | Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir | Alternative device type (subcutaneous reservoir) for intrathecal/epidural drug delivery; may be considered when a reservoir rather than a pump is appropriate. |
62361 | Implantation or replacement of device for intrathecal or epidural drug infusion; non‑programmable pump | Alternative to a programmable pump when a fixed-rate, non‑programmable device is used. |
62365 | Removal of previously implanted reservoir or pump | Often performed prior to or during replacement of a malfunctioning pump; may be billed in the same episode when removal is clinically indicated. |
62367 | Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion; without reprogramming | Post-implant or follow-up service to assess pump function; diagnostic analysis that may precede reprogramming or refill procedures. |
62368 | Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion; with reprogramming | Follow-up service that includes interrogation and adjustment of pump settings; commonly used after implantation of a programmable pump. |
95991 | Refill of implantable infusion pump | Maintenance service for medication refills of the implanted pump; commonly performed in outpatient or ambulatory settings though related to ongoing care after 62362. |
Commonly used together or as alternatives:
62365is commonly used when a previously implanted pump or reservoir must be removed before or during replacement with the device described by62362.62367and62368are commonly used post-implant for interrogation and programming of the programmable pump placed with62362.62361and62360represent alternative device types to62362and may be reported instead of62362when the device implanted differs.95991is commonly used in longitudinal care for refill maintenance after implantation with62362.
National Reimbursement Benchmarks
National commercial mean rates for CPT 62362 are substantially higher than the Medicare mean. The combined BUCA commercial mean ($528.11) and other large commercial payers (for example UnitedHealth Group at $717.63 and Cigna at $677.22) exceed the Medicare mean ($377.74) by a material margin, while Aetna’s mean ($344.38) is slightly below Medicare.
Rate dispersion (the difference between the 75th and 25th percentiles) varies across payers. UnitedHealth Group and Cigna show the widest dispersion (UHC: $389.00; Cigna: $368.17), indicating broader variability in allowed amounts. Aetna and Medicare are the tightest (Aetna: $183.00; Medicare: $30.00), indicating more concentrated payment distributions. The table and chart below present the full breakdown.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.