Needle aspiration from inside a spinal disc or nearby paravertebral tissue to get a sample for diagnosis, most often for suspected infection.
- Medicare
- $258.86
- Work RVU
- 2.93
- Global, days
- 0
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Clinical suspicion of infection with labs and MRI findings
- Level aspirated and approach
- Imaging guidance type with saved images
- Specimens sent for culture and pathology
- How the result will change treatment
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
62267 reports a percutaneous aspiration of the disc nucleus or paravertebral tissue for diagnosis. The usual reason is suspected discitis or vertebral osteomyelitis, where a culture changes the antibiotic plan. Spine surgeons, interventional radiologists, and pain physicians perform it.
Imaging guidance is reported separately, usually with fluoroscopic or CT guidance codes, when it is used and documented. The code covers one session. The procedure is not reported with discography or disc decompression codes at the same level, and it is not billed with a separate needle biopsy of the same site, because the payer sees the work as overlapping.
The denials come from vague indications. Payers want the clinical case for infection: fever, rising inflammatory markers, MRI findings, and a statement that the result will change treatment. This is a 0-day global, so a same-day E/M needs modifier 25 and its own documented decision. Send the specimen for culture and pathology and note it in the procedure record.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (2.93) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (7.75) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.93 |
| Practice expense RVU | 4.49 |
| Malpractice RVU | 0.33 |
| Total RVU | 7.75 |
| Medicare national rate | $258.86 |
| Global period | 0 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $258.86 |
HOPD (APC 5071) Hospital outpatient department | $723.47 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $388.55 |
Common denial reasons
The recurring reasons claims for CPT 62267 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with discography or disc decompression at the same level
- Imaging guidance billed without images or a report
- No clinical support for infection
- Same-day E/M without modifier 25
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Is imaging guidance included in CPT 62267?
02Can 62267 be billed with 62290?
03What is CPT 62267 used for?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe records the fever history, labs, and MRI findings that support a disc aspiration, so the indication is on the chart before the procedure.
See how Mira captures CPT 62267 documentation