Summary & Overview

CPT 62162: Endoscopic Colloid Cyst Resection with Ventricular Drainage

CPT code 62162 covers endoscopic intracranial surgery to remove or fenestrate a colloid cyst of the third ventricle with placement of an external ventricular catheter for drainage. This procedure addresses a benign but potentially obstructive lesion that can cause hydrocephalus and acute neurologic compromise; accurate coding is important for hospital billing, resource allocation, and quality measurement in neurosurgical care.

Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and an outline of common billing modifiers associated with complex operative care. The publication summarizes how the service is reported, typical care settings (hospital operating room and monitored inpatient units), and the clinical rationale for external ventricular drainage following endoscopic intervention.

The report highlights benchmarks and policy-relevant points relevant to payers and health systems: expected complexity of neurosurgical coding for endoscopic intracranial procedures, inpatient vs outpatient service implications, and implications for postoperative monitoring and resource use. Data not available in the input is clearly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 62162endoscopic neurosurgerycolloid cystventricular drainneurosurgical procedureintracranial surgeryoperating roominpatient care

Billing Code Overview

CPT code 62162 describes an endoscopic intracranial procedure to remove or create an opening to drain a colloid cyst in the third ventricle. The method uses a small endoscope introduced into the ventricular system to excise or fenestrate the thick, gel‑like benign lesion and includes placement of a ventricular catheter for external cerebrospinal fluid drainage.

Service Type: Endoscopic neurosurgical resection/drainage of intracranial colloid cyst with external ventricular catheter placement

Typical Site of Service: Hospital operating room or inpatient neurosurgical suite, with postoperative external ventricular drain management typically in an intensive care or monitored inpatient setting.

Clinical & Coding Specifications

Clinical Context

A 48-year-old patient presents to the emergency department with acute worsening headaches, episodic nausea, and intermittent loss of consciousness. Neuroimaging (non-contrast CT followed by MRI brain) demonstrates an intraventricular mass consistent with a colloid cyst in the anterior roof of the third ventricle causing obstructive hydrocephalus and ventriculomegaly. The neurosurgery team evaluates the patient and determines that endoscopic transventricular resection or fenestration of the colloid cyst with placement of an external ventricular drain (EVD) is indicated to relieve acute obstructive hydrocephalus and prevent further episodes of decreased consciousness.

The clinical workflow includes:

Initial stabilization in the ED with airway, breathing, circulation assessment and intracranial pressure management.
Urgent neuroimaging (CT and MRI) and neurosurgical consult.
Preoperative evaluation including informed consent, coagulation status, and anesthesia assessment.
In the operating room, the neurosurgeon uses a rigid or flexible neuroendoscope via a burr hole to access the lateral ventricle, navigate to the third ventricle, and either remove the colloid cyst or create an opening to drain it. A ventricular catheter is placed and connected to an external drainage system for temporary CSF diversion and monitoring.
Postoperative care in a neurosurgical ICU or step-down unit with neurologic checks, CSF drainage management, repeat imaging as indicated, and EVD removal when safe.
Typical site of service: inpatient hospital operating room with postoperative neurosurgical ICU or step-down unit.
Service type: endoscopic intracranial neurosurgical procedure for cyst removal or fenestration with placement of external ventricular drainage.

Coding Specifications

Modifier	Description	When to Use
`00`	Unspecified	Rarely used; avoid when a specific modifier applies
`11`	Normal service	When the procedure is performed without unusual effort or complications; denotes the primary service
`22`	Increased procedural services	When substantially greater work than typical is required due to technical difficulty or extensive dissection
`23`	Unusual anesthesia	When general anesthesia is substantially more risky or technically difficult than usual
`26`	Professional component	When billing only the surgeon's professional component separate from facility charges (rare for global hospital-based neurosurgery)
`50`	Bilateral procedure	If bilateral ventricular approach or bilateral simultaneous procedures are reported (uncommon for this code)
`52`	Reduced services	When the endoscopic procedure is partially performed or abbreviated compared with full service
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances prior to completion
`62`	Two surgeons	When two surgeons of different specialties or peer surgeons are required to perform portions of the case
`66`	Surgical team	When a surgical team performs this complex intracranial procedure requiring team approach
`78`	Return to the operating room for a related procedure during the global period	When an unplanned return to OR for a complication related to the initial procedure occurs during the global period
`80`	Assistant surgeon	When an assistant surgeon performs a substantive assisting role
`81`	Minimum assistant surgeon	When a minimal assisting role is documented
`62`	Two surgeons (duplicate entry removed if needed)	See above — used when two primary surgeons are required

Taxonomy Code	Specialty	Notes
`207RG0200X`	Neurological Surgery	Primary specialty performing endoscopic third ventricle procedures and EVD placement
`2080P0300X`	Pediatric Neurological Surgery	When procedure is performed in pediatric patients by subspecialized neurosurgeons
`207LH0000X`	Neurocritical Care	Postoperative critical care management in ICU
`2084N0400X`	Neurology	May be involved in preoperative and postoperative neurologic evaluation
`362E00000X`	Vascular Surgery (neurointerventional)	Rarely involved if concomitant endovascular procedures are needed

ICD-10 Code	Description	Clinical Relevance
`G93.5`	Compression of brain	Can reflect mass effect from a third ventricular colloid cyst causing increased intracranial pressure
`G91.0`	Communicating hydrocephalus	Hydrocephalus type that may be associated with ventricular obstruction from a cyst (sometimes used depending on physician documentation)
`G91.2`	Normal pressure hydrocephalus	Less commonly associated but included when ventricular drainage and evaluation are required in differential diagnosis
`S06.6X9A`	Traumatic subdural hemorrhage and injury of brain, initial encounter	Included only when traumatic intracranial injury coexists and requires CSF diversion (use with supporting documentation)
`D33.4`	Benign neoplasm of ventricular system	General code for benign intraventricular tumors such as colloid cysts when a specific code for colloid cyst is not used

CPT Code	Description	Relationship to This Procedure
`62162`	Endoscopic removal or fenestration of colloid cyst; with placement of a ventricular catheter for external drainage	Primary procedure: endoscopic transventricular colloid cyst removal or drainage with EVD placement
`61154`	Ventricular catheter, temporary, for drainage of cerebrospinal fluid (includes percutaneous insertion and subcutaneous tunneling)	May be used when separate reporting for EVD insertion technique is required in specific billing contexts
`61304`	Craniotomy for excision of lesion, supratentorial or infratentorial; microdissection technique	Alternative open approach code when endoscopic approach is converted to open craniotomy for cyst resection
`99152`	Anesthesia for procedures on the head or neck (example code for moderate sedation—use actual anesthesia codes per payer)	Anesthesia-related services provided during the procedure; use appropriate anesthesia CPT codes as applicable
`99291`	Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes	Postoperative ICU critical care services frequently billed during initial postoperative management

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