CPT code 62143: Skull reconstruction, bone flap or plate replacement2026 Medicare rate & RVUs in California
Report this service when a surgeon replaces a cranial bone flap or prosthetic plate during operative reconstruction of the skull.
CMS doesn’t publish an office rate for 62143 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 62143 covers
A neurosurgeon or other qualified surgeon uses this code for operative replacement of a bone flap or prosthetic plate in the skull. The service involves restoring the cranial covering with the replaced bone or plate; it is distinct from simply removing the flap or plate and from reconstructing a defect with a newly obtained graft. These cases are generally performed in a hospital or other surgical facility.
Select the code when the operative report documents replacement of the bone flap or prosthetic plate, including the site and the work performed. It has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 62143 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,015.81 |
| Chico, CA | Unavailable | $1,001.16 |
| El Centro, CA | Unavailable | $1,002.10 |
| Fresno, CA | Unavailable | $1,001.16 |
| Hanford, CA | Unavailable | $1,001.16 |
| Los Angeles, CA | Unavailable | $1,070.56 |
| Madera, CA | Unavailable | $1,001.16 |
| Marin County, CA | Unavailable | $1,146.29 |
| Merced, CA | Unavailable | $1,001.16 |
| Modesto, CA | Unavailable | $1,001.16 |
| Napa, CA | Unavailable | $1,104.52 |
| Oxnard, CA | Unavailable | $1,056.46 |
| Redding, CA | Unavailable | $1,001.16 |
| Rest of California | Unavailable | $1,001.16 |
| Riverside, CA | Unavailable | $1,061.23 |
| Sacramento, CA | Unavailable | $1,036.30 |
| Salinas, CA | Unavailable | $1,032.42 |
| San Benito County, CA | Unavailable | $1,180.28 |
| San Diego, CA | Unavailable | $1,047.66 |
| San Francisco, CA | Unavailable | $1,139.89 |
| San Luis Obispo, CA | Unavailable | $1,018.10 |
| Santa Clara County, CA | Unavailable | $1,154.14 |
| Santa Cruz, CA | Unavailable | $1,049.87 |
| Santa Maria, CA | Unavailable | $1,033.80 |
| Santa Rosa, CA | Unavailable | $1,059.14 |
| Stockton, CA | Unavailable | $1,001.16 |
| Vallejo, CA | Unavailable | $1,095.31 |
| Visalia, CA | Unavailable | $1,001.16 |
| Yuba City, CA | Unavailable | $1,001.16 |
How the 62143 rate is calculated
Each of 62143’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 62143
RVUs × geographic indexes × conversion factor
Work13.80
13.80 RVUs× 1.000 GPCI
Practice expense11.79
11.79 RVUs× 1.000 GPCI
Malpractice5.63
5.63 RVUs× 1.000 GPCI
Adjusted RVUs
31.2200
Conversion factor
$33.4009
Medicare rate
$1,042.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 62143
62143 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 62143
Skull reconstruction, bone flap or plate replacement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 62143
Skull reconstruction, bone flap or plate replacement
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
62143 without 51 · national facility
$1,042.78
Skull reconstruction, bone flap or plate replacement
62143-51 · Second procedure: 50%
$521.39
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
62143 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 62142Cranial implant removalBone flap or prosthetic plate
- Use 62143 when the service replaces a bone flap or prosthetic plate. Code 62142 describes removal, not replacement.
- 62140CranioplastyDefect under 5 cm
- 62140 addresses cranial defect repair for a defect under the size threshold; 62143 describes replacement of a flap or plate.
- 62146CranioplastyAutograft, under 5 cm
- 62146 is skull reconstruction using an autograft for a smaller defect. Choose 62143 when the service is replacement of a bone flap or prosthetic plate.
- 62148Bone flap repairRepositioning during skull repair
- 62148 describes repositioning an existing bone flap. 62143 is for replacing a flap or plate.
62143 billing questions
How does 62143 differ from 62142?
62143 is for replacing a cranial bone flap or prosthetic plate; 62142 describes removal. Base the selection on the operative service documented, not simply on the fact that a flap or plate was present.
Should modifier 50 be used for replacement on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What should the operative note establish?
Document that a bone flap or prosthetic plate was replaced, its cranial site, and the operative work performed. The record should distinguish replacement from removal alone or reconstruction using a new graft.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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