FeeBase
Log inGet started
Menu

Billing code 62120: Encephalocele repairMedicare rate & RVUs

Repair of an extradural skull-base encephalocele, reported when the surgeon closes the defect and addresses the herniated contents.

CMS RVU26DEffective Oct 1, 2026109 payment localities69 Medicare services in 2024

Medicare pays $2,144.67 for 62120 nationally in a facility.

Medicare rate · 62120

Encephalocele repair

Swap in your local Medicare rate.

Work RVUs
23.98
Total RVUs
64.21
Global days
090

National rate · 2026

$2,144.67

Facility setting, before claim adjustments.

See every locality for 62120 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 62120 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 62120 covers

This service repairs an encephalocele at the skull base when the repair is extradural. An encephalocele is a protrusion of meninges, sometimes with brain tissue, through a skull defect. Neurosurgeons and skull-base surgeons, including otolaryngologists working with a neurosurgical team, may perform the operation in a hospital operating room. The operative report should identify the skull-base site, the encephalocele, and the extradural nature of the repair.

Choose this code for the extradural repair, not the intradural repair represented by 62121 or a procedure directed only at a cerebrospinal-fluid leak. Documentation should make the pathology and surgical approach clear. Medicare assigns a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery services 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 62120 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

62120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,872.16
Alaska*Unavailable$2,458.58
ArizonaUnavailable$2,064.78
ArkansasUnavailable$1,838.81
AtlantaUnavailable$2,231.17
AustinUnavailable$2,166.01
BakersfieldUnavailable$2,124.11
Baltimore/Surr. CntysUnavailable$2,311.07
BeaumontUnavailable$2,030.17
BrazoriaUnavailable$2,067.59

62120 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
62120 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 62120 rate is calculated

Each of 62120’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 · 62120

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 23.98Practice expense 30.10Malpractice 10.13

64.2100 adjusted RVUs×$33.4009 conversion factor=$2,144.67

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 62120

62120 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 62120

Encephalocele repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 62120

Encephalocele repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

62120 without 51 · national facility

$2,144.67

Encephalocele repair

62120-51 · Second procedure: 50%

$1,072.34

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%).

When to use modifier 51

62120 compared with similar codes

Compare codes

62120 vs 62121 vs 62100 vs 62140 vs 62141: national Medicare rates

Swap in your local Medicare rate.

  • 62120
    Encephalocele repair · 23.98 wRVU
    —
  • 62121
    Skull-base repair · 22.45 wRVU
    —
  • 62100
    Brain fluid leak repair · 22.94 wRVU
    —
  • 62140
    Cranioplasty · 14.19 wRVU
    —
  • 62141
    Cranioplasty · 15.67 wRVU
    —

How to choose

62121Skull-base repair
Use 62120 for an extradural skull-base encephalocele repair and 62121 when the repair is intradural.
62100Brain fluid leak repair
62100 addresses repair for a CSF leak; 62120 is for an extradural skull-base encephalocele.
62140Cranioplasty
62140 is cranioplasty for a skull defect measuring up to 5 cm, rather than repair of a skull-base encephalocele.
62141Cranioplasty
62141 is cranioplasty for a skull defect larger than 5 cm; it is not the extradural encephalocele repair described by 62120.

Codes related to 62120

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 62120
CodeHow it relatesNational office range
Same family
62121Skull-base repairThe intradural counterpart for skull-base encephalocele repair.No office rate
Used instead
62100Brain fluid leak repairMay be the relevant repair code for a CSF leak without an encephalocele.No office rate
62140CranioplastyCranioplasty for a small skull defect rather than skull-base encephalocele repair.No office rate

62120 billing questions

How do I distinguish 62120 from 62121?

The distinction is whether the skull-base encephalocele repair is extradural or intradural. The operative report should support the documented plane of repair.

Is this the code for repair of a CSF leak alone?

No. This code describes extradural repair of a skull-base encephalocele. A repair directed at a CSF leak without an encephalocele may point to 62100 instead.

Can I append modifier 50 for repair on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative services are included?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

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%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.

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
RVUs for 62120PPRRVU2026_Oct_nonQPP.csv, line 6,913 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 62120 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 62120 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →