CPT 62270: Diagnostic Spinal Puncture for CSF Sampling
Medicare pays $170 and commercial payers pay $379 on average nationally for this procedure.
CPT code 62270 describes a diagnostic spinal puncture procedure in which a provider obtains a cerebrospinal fluid (CSF) sample for laboratory examination, commonly performed to evaluate suspected central nervous system infections such as meningitis; service type: diagnostic procedure; typical site of service: hospital inpatient or outpatient setting, emergency department, or ambulatory surgical center where lumbar punctures are performed.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Medicare’s mean rate for CPT 62270 sits near $170.30, notably lower than BUCA’s average commercial mean of $378.80, indicating a substantial gap between public and average commercial reimbursement for this code. This spread suggests commercial contracts with BUCA pay, on average, roughly $208.50 more than Medicare for the same service.
Dispersion varies by payer: Blue Cross Blue Shield exhibits the widest interquartile spread (P75–P25 = $356.00), while Aetna is relatively tight (P75–P25 = $87.30). UnitedHealth Group and Cigna show moderate spreads of $138.00 and $139.60 respectively, and BUCA’s interquartile spread is $236.80. These differences indicate that commercial markets differ substantially in rate consistency, with Blue Cross Blue Shield showing the greatest variability and Aetna the least.