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Billing code 62121: Skull-base repairMedicare rate & RVUs

Reports open surgical repair of a skull-base encephalocele, where herniated intracranial contents pass through a defect in the skull base.

CMS RVU26DEffective Oct 1, 2026109 payment localities267 Medicare services in 2024

Medicare pays $1,433.23 for 62121 nationally in a facility.

Medicare rate · 62121

Skull-base repair

Swap in your local Medicare rate.

Work RVUs
22.45
Total RVUs
42.91
Global days
090

National rate · 2026

$1,433.23

Facility setting, before claim adjustments.

See every locality for 62121 → · 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 62121 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 62121 covers

A neurosurgeon repairs a skull-base defect associated with an encephalocele, in which intracranial tissue or its coverings protrude through the skull. The operation uses an open skull approach to address the defect and may include reconstruction needed to complete the repair. These cases are typically performed in a hospital operating room, often with neurosurgery and other surgical specialists involved when the anatomy requires it.

Report 62121 for the documented skull-base encephalocele repair, rather than a general repair of a cerebrospinal fluid leak or reconstruction of a separate skull defect. The operative note should identify the encephalocele, the skull-base defect, and the repair performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; 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 62121 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

62121 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,286.50
Alaska*Unavailable$1,750.60
ArizonaUnavailable$1,389.63
ArkansasUnavailable$1,268.63
AtlantaUnavailable$1,483.12
AustinUnavailable$1,440.24
BakersfieldUnavailable$1,416.46
Baltimore/Surr. CntysUnavailable$1,527.65
BeaumontUnavailable$1,375.50
BrazoriaUnavailable$1,391.22

62121 rates by state

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

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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
62121 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 62121 rate is calculated

Each of 62121’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 · 62121

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.45Practice expense 14.52Malpractice 5.94

42.9100 adjusted RVUs×$33.4009 conversion factor=$1,433.23

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

Payment rules and modifiers for 62121

62121 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 62121

Skull-base 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 · 62121

Skull-base 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

62121 without 51 · national facility

$1,433.23

Skull-base repair

62121-51 · Second procedure: 50%

$716.62

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

62121 compared with similar codes

Compare codes

62121 vs 62100 vs 62120 vs 62140: national Medicare rates

Swap in your local Medicare rate.

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

How to choose

62100Brain fluid leak repair
62121 describes repair of a skull-base encephalocele. Code 62100 is directed to repair of a dural or cerebrospinal fluid leak.
62120Encephalocele repair
Both concern skull-base encephalocele repair. Use the full billing code descriptors and documented operative details to determine which procedure was performed.
62140Cranioplasty
62140 is cranioplasty for a skull defect. It is not a substitute for a skull-base encephalocele repair.

Codes related to 62121

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

Codes related to 62121
CodeHow it relatesNational office range
Same family
62120Encephalocele repairRelated skull-base encephalocele repair code; select by the specific procedure documented.No office rate
Used instead
62100Brain fluid leak repairUsed for repair of a dural or cerebrospinal fluid leak rather than this encephalocele repair.No office rate
62140CranioplastyCovers cranioplasty for a skull defect, not skull-base encephalocele repair.No office rate
62141CranioplastyCranioplasty for a larger skull defect is distinct from encephalocele repair.No office rate

62121 billing questions

When should 62121 be selected instead of 62100?

Use 62121 for repair of a skull-base encephalocele. Code 62100 describes repair of a dural or cerebrospinal fluid leak, so the operative indication and work performed distinguish the services.

How is 62121 distinguished from 62120?

Both codes concern skull-base encephalocele repair. Confirm the specific procedure performed against the full billing code descriptors and operative report before choosing between them.

Can modifier 50 be appended when the repair involves both sides?

No. CMS identifies modifier 50 as inappropriate for this service; report the procedure without a bilateral adjustment.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care. A separately reportable service must be distinct from that included care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure reduction, CMS pays the highest-valued procedure in full and other procedures at 50%.

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 62121PPRRVU2026_Oct_nonQPP.csv, line 6,914 (RVU26D)

Open CMS sourceHow we calculate rates

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