Fluoroscopy guided lumbar puncture w/ Sedation

Billed together on one claim

62329 99152

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Price for scenario

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Fee schedule

2026 Medicare PFS · RVU26D

Effective October 1, 2026 · CF $33.4009

Locality

San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09)

Setting · provider

Facility rates · Physician

Payer

Traditional Medicare

Priced as of

November 13, 2026

Medicare allowed

$111.79

Total the claim is paid on

Medicare pays

$87.64

80%, less 2% sequestration

Patient owes

$22.36

20% coinsurance, once the Part B deductible is met

Billing rules changed it by

—

from $111.79 at full fee schedule

Nothing to resolve before billing: no prior authorization, documentation or coding flags for these codes.

Highest-paid first, the order Medicare ranks multiple procedures

Code	Description	Units	Fee schedule	× Units	Adjustments	Allowed
62329	Ther spi pnxr csf fluor/ct	1	$99.72	$99.72	—	$99.72
99152	Mod sed same phys/qhp 5/>yrs	1	$12.07	$12.07	—	$12.07
Total				$111.79	—	$111.79

Before the Part B deductible

Until the patient meets the annual Part B deductible, they pay the full allowed amount instead of 20% coinsurance.

How each fee is calculated (Work RVU × GPCI + PE RVU × GPCI + MP RVU × GPCI) × conversion factor ▸

Code	Work	Practice expense	Malpractice	Adjusted RVU	× CF	Fee	Global	Multiple procedure	Bilateral (50)	Assistant	Co-surgeon (62)
62329	1.98 × 1.11	0.45 × 1.442 facility	0.35 × 0.397	2.9857	33.4009	$99.72	0-day global	Standard (2nd+ at 50%)	No bilateral adjustment	Not paid	Not permitted
99152	0.25 × 1.11	0.05 × 1.442 facility	0.03 × 0.397	0.3615	33.4009	$12.07	No global period	Not applicable	Not applicable	Not applicable	Not applicable

GPCIs for San Jose Sunnyvale Santa Clara (Santa Clara Cnty), CA (01112-09) in RVU26D. Imaging fees are capped at the OPPS amount when that's lower.