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Billing code 63709: CSF leak repairMedicare rate & RVUs

Repair a spinal dural or cerebrospinal fluid leak when a laminectomy is required to expose and close the defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities697 Medicare services in 2024

Medicare pays $1,084.86 for 63709 nationally in a facility.

Medicare rate · 63709

CSF leak repair

Work RVUs
15.26
Total RVUs
32.48
Global days
090

National rate · 2026

$1,084.86

Facility setting, before claim adjustments.

See every locality for 63709 →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 63709 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 63709 covers

This code describes operative repair of a spinal dural defect that is leaking cerebrospinal fluid and requires a laminectomy for access. A neurosurgeon or spine surgeon may perform it in a hospital operating room for a leak identified during or after spinal surgery, or for another documented spinal dural defect. The operative work centers on exposing the leak through the required bony removal and repairing the defect to stop fluid escape.

Select this code when the operative report supports both the CSF leak repair and the need for a laminectomy to reach it; a leak repair performed without laminectomy is represented by 63707. The report should identify the defect, leakage, surgical exposure, and repair performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 63709 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

63709 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$958.99
Alaska*Unavailable$1,287.31
ArizonaUnavailable$1,047.29
ArkansasUnavailable$943.67
AtlantaUnavailable$1,127.91
AustinUnavailable$1,089.19
BakersfieldUnavailable$1,064.69
Baltimore/Surr. CntysUnavailable$1,163.65
BeaumontUnavailable$1,036.42
BrazoriaUnavailable$1,046.90

63709 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
63709 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 63709 rate is calculated

Each of 63709’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 · 63709

RVUs × geographic indexes × conversion factor

Work15.26

15.26 RVUs× 1.000 GPCI

Practice expense11.99

11.99 RVUs× 1.000 GPCI

Malpractice5.23

5.23 RVUs× 1.000 GPCI

Adjusted RVUs

32.4800

Conversion factor

$33.4009

Medicare rate

$1,084.86

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 63709

63709 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63709

CSF leak 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 · 63709

CSF leak 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

63709 without 51 · national facility

$1,084.86

CSF leak repair

63709-51 · Second procedure: 50%

$542.43

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

63709 compared with similar codes

Compare codes · National

4 codes, side by side

  • 63709

    CSF leak repair15.26 wRVU

    Not priced

  • 63707

    Spinal leak repair12.33 wRVU

    Not priced

  • 63710

    Dural repair15.02 wRVU

    Not priced

  • 63700

    Meningocele repair17.03 wRVU

    Not priced

How to choose

63707Spinal leak repair
Both address spinal dural or CSF leakage. Choose 63709 when laminectomy is required for access; 63707 describes repair without that requirement.
63710Dural repair
63710 describes a spinal dural graft procedure. 63709 describes repair of a leaking dural defect requiring laminectomy; report graft work only when separately supported.
63700Meningocele repair
63700 is for spinal meningocele repair, not repair of a spinal dural or CSF leak requiring laminectomy.

Codes related to 63709

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

Codes related to 63709
CodeHow it relatesNational office range
Same family
63707Spinal leak repairRepair of a spinal dural or CSF leak when laminectomy is not required.No office rate
63700Meningocele repairA spinal meningocele repair code, for a different lesion than a CSF leak.No office rate
Often billed with
63710Dural repairA spinal dural graft may accompany repair when graft placement is documented.No office rate

63709 billing questions

How is 63709 different from 63707?

63709 is for repair of a spinal dural or CSF leak requiring laminectomy for access. Use 63707 when the leak repair does not require laminectomy.

What documentation supports reporting 63709?

The operative report should describe the spinal dural defect and CSF leakage, the laminectomy needed to expose it, and the repair performed.

Can modifier 50 be appended?

No. Modifier 50 is inappropriate for this code's anatomy.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.

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 63709PPRRVU2026_Oct_nonQPP.csv, line 7,090 (RVU26D)

Open CMS sourceHow we calculate rates

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