CPT code 62146: Cranioplasty, autograft, under 5 cm2026 Medicare rate & RVUs in Missouri
Reconstructs a cranial defect under 5 cm using the patient’s own bone, such as after a craniectomy or traumatic skull injury.
CMS doesn’t publish an office rate for 62146 in Missouri.
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 62146 covers
A neurosurgeon uses the patient’s own bone to rebuild a skull defect measuring less than 5 cm in diameter. The graft may be used to restore cranial protection and contour after a prior craniectomy, traumatic injury, or removal of bone during treatment of an intracranial condition. This procedure is typically performed in an operating room in a hospital or other surgical facility.
Report this code when the documented repair includes an autograft and the defect meets the code’s size criterion; document the defect measurement and the use of the patient’s bone. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 62146 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,210.69 |
| Metropolitan St. Louis, MO | Unavailable | $1,222.38 |
| Rest of Missouri | Unavailable | $1,175.85 |
How the 62146 rate is calculated
Each of 62146’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 · 62146
RVUs × geographic indexes × conversion factor
Work16.85
16.85 RVUs× 1.000 GPCI
Practice expense13.27
13.27 RVUs× 1.000 GPCI
Malpractice7.10
7.10 RVUs× 1.000 GPCI
Adjusted RVUs
37.2200
Conversion factor
$33.4009
Medicare rate
$1,243.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 62146
62146 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 62146
Cranioplasty, autograft, under 5 cm
| 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 · 62146
Cranioplasty, autograft, under 5 cm
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
62146 without 51 · national facility
$1,243.18
Cranioplasty, autograft, under 5 cm
62146-51 · Second procedure: 50%
$621.59
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%).
62146 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 62140CranioplastyDefect under 5 cm
- Both address a skull defect under 5 cm, but 62146 includes reconstruction with the patient’s own bone; 62140 is for cranioplasty without that autograft.
- 62141CranioplastyDefect over 5 cm
- 62141 describes cranioplasty without autograft for a defect greater than 5 cm. For 62146, the defect is under 5 cm and an autograft is used.
- 62147CranioplastyAutograft, defect over 5 cm
- Both include autograft cranioplasty. Choose 62146 for a defect under 5 cm and 62147 for a defect greater than 5 cm.
62146 billing questions
How is this code distinguished from 62140?
62146 describes reconstruction using the patient’s own bone for a defect under 5 cm. 62140 is the corresponding small-defect cranioplasty without an autograft.
When should 62147 be considered?
Use 62147 for cranioplasty with autograft when the defect is greater than 5 cm in diameter. Document the measured defect and the graft used.
What documentation supports 62146?
The operative report should establish the defect’s diameter, the reconstruction performed, and that the graft was the patient’s own bone.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be available for this procedure. Co-surgeon payment requires supporting documentation.
How does the global period affect postoperative care?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Should modifier 50 be used for defects on both sides?
No. Modifier 50 is inappropriate for this code; the descriptor and anatomy do not support bilateral adjustment.
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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