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CPT 62201: Endoscopic Ventriculocisternostomy for Hydrocephalus

CPT code 62201 identifies an endoscopic ventriculocisternostomy performed with stereotactic imaging guidance to create an opening between the third ventricle and the cisterna magna, most commonly used to treat noncommunicating hydrocephalus. This procedure matters nationally because it represents a minimally invasive neurosurgical alternative to shunt placement for selected patients with obstructive CSF flow, with implications for outcomes, utilization, and payer coverage policies.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when the procedure is used, typical sites of service, and how CPT code 62201 is classified in surgical billing. The publication outlines payer coverage considerations and common modifier use where available, and summarizes the procedural role of ventriculocisternostomy relative to other CSF-diversion strategies.

This overview is intended for clinicians, coding professionals, and policy analysts seeking a concise reference on CPT code 62201, including expected clinical indications, service setting, and the types of coverage discussions that typically accompany advanced neurosurgical endoscopic procedures. Data not available in the input is explicitly omitted.

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Billing Code Overview

CPT code 62201 describes an endoscopic ventriculocisternostomy performed with stereotactic imaging guidance. In this procedure the provider uses a small endoscope to access the brain and creates an artificial opening in the floor of the third ventricle to the cisterna magna to restore cerebrospinal fluid (CSF) flow. The procedure is most often performed to treat noncommunicating hydrocephalus and allows CSF to drain internally within the patient.

Service type: Neurosurgical endoscopic CSF diversion procedure (ventriculocisternostomy)

Typical site of service: Hospital operating room or specialized neurosurgical suite (inpatient or outpatient surgical setting depending on clinical indication and patient status)

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CPT 62201: Endoscopic Ventriculocisternostomy for Hydrocephalus

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Billing Code Overview

Service type: Neurosurgical endoscopic CSF diversion procedure (ventriculocisternostomy)

Typical site of service: Hospital operating room or specialized neurosurgical suite (inpatient or outpatient surgical setting depending on clinical indication and patient status)

Clinical & Coding Specifications

Clinical Context

A typical patient is a 6-month-old infant or a 45-year-old adult presenting with signs of increased intracranial pressure such as progressive head enlargement (infants), persistent vomiting, lethargy, papilledema, or gait disturbance. Imaging (CT or MRI) demonstrates obstructive (noncommunicating) hydrocephalus—commonly aqueductal stenosis or a tumor obstructing CSF flow—where endoscopic third ventriculostomy (ETV) is appropriate. The neurosurgical team obtains informed consent, performs preoperative imaging with stereotactic planning, and admits the patient to an operating room or neurointerventional suite. Under general anesthesia, the surgeon makes a small burr hole, inserts a rigid neuroendoscope into the lateral ventricle, advances to the third ventricle, and uses electrocautery or a balloon to create an ostomy in the floor of the third ventricle to allow CSF diversion to the prepontine cistern (cisterna magna). Intraoperative stereotactic imaging guidance and endoscopic visualization confirm patency. The patient is recovered in a post-anesthesia care unit and monitored in a pediatric or neurosurgical ward or intensive care unit depending on condition. Postoperative MRI or CT and serial neurologic exams evaluate success and complications such as hemorrhage or infection.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier / standard code use	Use when no additional modifier applies to the service.
`11`	Usually the default treatment	Rarely used; when this service represents the usual, expected level of service provided by the surgeon.
`22`	Increased procedural services	Use when work or resources required are substantially greater than typically required (document additional work).
`23`	Unusual anesthesia	Use when general anesthesia is not used and anesthesia is significantly elevated or unusual circumstances occur.
`26`	Professional component	Use when billing only the surgeon’s professional component separated from facility or technical components.
`52`	Reduced services	Use when the procedure is started but discontinued or performed at a reduced level (document reasons).
`53`	Discontinued procedure	Use when procedure is terminated due to extenuating circumstances prior to completion.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the ETV.
`63`	Procedure performed on infants less than 4 kg	Use in specific payor policies when newborn/low-weight infant modifiers are required.
`78`	Return to OR for related procedure during postoperative period	Use when a related operative procedure for a complication (e.g., hemorrhage) is performed during the global period.
`79`	Unrelated procedure during global period	Use when an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides surgical assistance (billing for assistant).
`81`	Minimum assistant surgeon	Use when a minimal assistance was provided by a qualified assistant.
`82`	Assistant surgeon when qualified resident unavailable	Use when a qualified resident is not available and an assistant is used.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use to indicate services performed by a nonphysician practitioner when permitted.

Taxonomy Code	Specialty	Notes
`207X00000X`	Neurological Surgery	Primary specialty performing `62201` (endoscopic third ventriculostomy).
`2084P0800X`	Pediatric Neurological Surgery	Pediatric specialists performing ETV in infants and children.
`208000000X`	Neurology	Consulting neurologists involved pre- and postoperatively (not typically billing the procedure).
`2086S0127X`	Interventional Neuroradiology	May perform stereotactic planning or intraoperative imaging guidance support.
`363L00000X`	Neurocritical Care	Critical care specialists managing postoperative intensive care when needed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G91.0`	Hydrocephalus, communicating	Hydrocephalus diagnosis; ETV is indicated for obstructive and some communicating types when appropriate.
`G91.1`	Hydrocephalus, noncommunicating	Primary indication for `62201`; ETV creates an internal CSF bypass for obstructive hydrocephalus.
`Q03.9`	Congenital hydrocephalus, unspecified	Pediatric patients with congenital ventricular obstruction may undergo ETV.
`G93.5`	Compression of brain	Mass effect from tumors or cysts causing obstructive hydrocephalus; ETV can relieve CSF pressure.
`D33.3`	Benign neoplasm of brain, third ventricle	Lesions obstructing CSF pathways may be managed with ETV as part of surgical plan.
`C71.8`	Malignant neoplasm of brain, overlapping sites	Tumors causing obstruction of CSF flow; ETV may be performed to treat hydrocephalus symptomatically.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`62140`	Craniectomy for excision of lesion of brain (for example, biopsy, open removal)	May be performed if a concurrent open approach is required for tumor resection causing obstructive hydrocephalus.
`61783`	Stereotactic computer-assisted (neuronavigation) procedure, cranial; with intraoperative imaging	Used for stereotactic imaging guidance during ventricular endoscopic procedures.
`62223`	Injection for contrast or myelography, lumbar or cervical (diagnostic) — note: lumbar procedures differ	Occasionally performed pre- or postoperatively for CSF flow studies in complex cases (use as clinically indicated).
`61253`	Transnasal endoscopic excision or drainage procedures (skull base)	Performed when endoscopic skull base approaches are needed for lesions contributing to CSF flow obstruction.
`99152`	Anesthesia for procedures on the brain and spinal cord; complex (used historically)	Anesthesia services are reported separately and correlate with the complexity of neurosurgical procedures.

CPT 62180: Ventricular to Cisterna Magna Shunt Placement

CPT-62190-CEREBROSPINAL-FLUID-SHUNT-TO-CARDIAC-OR-JUGULAR-DRAINAGE

CPT 62190: Cerebrospinal Fluid Shunt to Cardiac or Jugular Drainage

CPT-62192-CEREBROSPINAL-FLUID-SHUNT-PLACEMENT-HYDROCEPHALUS

CPT 62192: Cerebrospinal Fluid Shunt Placement for Hydrocephalus

CPT-62194-INTRACRANIAL-SHUNT-CATHETER-REPLACEMENT-OR-FLUSHING

CPT 62194: Intracranial Shunt Catheter Replacement or Flushing

CPT-62200-VENTRICULOCISTERNOSTOMY-THIRD-VENTRICLE-FENESTRATION

CPT 62200: Ventriculocisternostomy for Hydrocephalus

CPT-62220-CSF-SHUNT-PLACEMENT-VENTRICULAR-DRAINAGE

CPT 62220: Ventricular to Venous CSF Shunt Placement

CPT-62223-VENTRICULAR-SHUNT-PLACEMENT-CSF-DIVERSION

CPT 62223: Ventricular Shunt Placement for CSF Diversion

CPT-62225-VENTRICULAR-CATHETER-REPLACEMENT-FLUSH-CSF-DRAINAGE

CPT 62225: Ventricular Catheter Replacement or Flush for CSF Drainage

CPT-62230-CSF-SHUNT-REVISION-OR-REPLACEMENT

CPT 62230: Revision or Replacement of Malfunctioning CSF Shunt

CPT-62252-PROGRAMMABLE-SHUNT-REPROGRAMMING-CSF-DRAINAGE

CPT 62252: Programmable Shunt Reprogramming for CSF Drainage

Showing 1–10 of 12

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier / standard code use	Use when no additional modifier applies to the service.
`11`	Usually the default treatment	Rarely used; when this service represents the usual, expected level of service provided by the surgeon.
`22`	Increased procedural services	Use when work or resources required are substantially greater than typically required (document additional work).
`23`	Unusual anesthesia	Use when general anesthesia is not used and anesthesia is significantly elevated or unusual circumstances occur.
`26`	Professional component	Use when billing only the surgeon’s professional component separated from facility or technical components.
`52`	Reduced services	Use when the procedure is started but discontinued or performed at a reduced level (document reasons).
`53`	Discontinued procedure	Use when procedure is terminated due to extenuating circumstances prior to completion.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the ETV.
`63`	Procedure performed on infants less than 4 kg	Use in specific payor policies when newborn/low-weight infant modifiers are required.
`78`	Return to OR for related procedure during postoperative period	Use when a related operative procedure for a complication (e.g., hemorrhage) is performed during the global period.
`79`	Unrelated procedure during global period	Use when an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon provides surgical assistance (billing for assistant).
`81`	Minimum assistant surgeon	Use when a minimal assistance was provided by a qualified assistant.
`82`	Assistant surgeon when qualified resident unavailable	Use when a qualified resident is not available and an assistant is used.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use to indicate services performed by a nonphysician practitioner when permitted.

Taxonomy Code	Specialty	Notes
`207X00000X`	Neurological Surgery	Primary specialty performing `62201` (endoscopic third ventriculostomy).
`2084P0800X`	Pediatric Neurological Surgery	Pediatric specialists performing ETV in infants and children.
`208000000X`	Neurology	Consulting neurologists involved pre- and postoperatively (not typically billing the procedure).
`2086S0127X`	Interventional Neuroradiology	May perform stereotactic planning or intraoperative imaging guidance support.
`363L00000X`	Neurocritical Care	Critical care specialists managing postoperative intensive care when needed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G91.0`	Hydrocephalus, communicating	Hydrocephalus diagnosis; ETV is indicated for obstructive and some communicating types when appropriate.
`G91.1`	Hydrocephalus, noncommunicating	Primary indication for `62201`; ETV creates an internal CSF bypass for obstructive hydrocephalus.
`Q03.9`	Congenital hydrocephalus, unspecified	Pediatric patients with congenital ventricular obstruction may undergo ETV.
`G93.5`	Compression of brain	Mass effect from tumors or cysts causing obstructive hydrocephalus; ETV can relieve CSF pressure.
`D33.3`	Benign neoplasm of brain, third ventricle	Lesions obstructing CSF pathways may be managed with ETV as part of surgical plan.
`C71.8`	Malignant neoplasm of brain, overlapping sites	Tumors causing obstruction of CSF flow; ETV may be performed to treat hydrocephalus symptomatically.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`62140`	Craniectomy for excision of lesion of brain (for example, biopsy, open removal)	May be performed if a concurrent open approach is required for tumor resection causing obstructive hydrocephalus.
`61783`	Stereotactic computer-assisted (neuronavigation) procedure, cranial; with intraoperative imaging	Used for stereotactic imaging guidance during ventricular endoscopic procedures.
`62223`	Injection for contrast or myelography, lumbar or cervical (diagnostic) — note: lumbar procedures differ	Occasionally performed pre- or postoperatively for CSF flow studies in complex cases (use as clinically indicated).
`61253`	Transnasal endoscopic excision or drainage procedures (skull base)	Performed when endoscopic skull base approaches are needed for lesions contributing to CSF flow obstruction.
`99152`	Anesthesia for procedures on the brain and spinal cord; complex (used historically)	Anesthesia services are reported separately and correlate with the complexity of neurosurgical procedures.

CPT 62180: Ventricular to Cisterna Magna Shunt Placement

CPT-62190-CEREBROSPINAL-FLUID-SHUNT-TO-CARDIAC-OR-JUGULAR-DRAINAGE

CPT 62190: Cerebrospinal Fluid Shunt to Cardiac or Jugular Drainage

CPT-62192-CEREBROSPINAL-FLUID-SHUNT-PLACEMENT-HYDROCEPHALUS

CPT 62192: Cerebrospinal Fluid Shunt Placement for Hydrocephalus

CPT-62194-INTRACRANIAL-SHUNT-CATHETER-REPLACEMENT-OR-FLUSHING

CPT 62194: Intracranial Shunt Catheter Replacement or Flushing

CPT-62200-VENTRICULOCISTERNOSTOMY-THIRD-VENTRICLE-FENESTRATION

CPT 62200: Ventriculocisternostomy for Hydrocephalus

CPT-62220-CSF-SHUNT-PLACEMENT-VENTRICULAR-DRAINAGE

CPT 62220: Ventricular to Venous CSF Shunt Placement

CPT-62223-VENTRICULAR-SHUNT-PLACEMENT-CSF-DIVERSION

CPT 62223: Ventricular Shunt Placement for CSF Diversion

CPT-62225-VENTRICULAR-CATHETER-REPLACEMENT-FLUSH-CSF-DRAINAGE

CPT 62225: Ventricular Catheter Replacement or Flush for CSF Drainage

CPT-62230-CSF-SHUNT-REVISION-OR-REPLACEMENT

CPT 62230: Revision or Replacement of Malfunctioning CSF Shunt

CPT-62252-PROGRAMMABLE-SHUNT-REPROGRAMMING-CSF-DRAINAGE

CPT 62252: Programmable Shunt Reprogramming for CSF Drainage

Showing 1–10 of 12

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 62201: Endoscopic Ventriculocisternostomy for Hydrocephalus

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Billing Code Overview

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CPT 62201: Endoscopic Ventriculocisternostomy for Hydrocephalus

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References