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CPT 63746: Shunt removalMedicare rate & RVUs

Reports operative removal of an implanted spinal cerebrospinal-fluid shunt when the device is taken out, rather than revised or newly placed.

CMS RVU26DEffective Oct 1, 2026109 payment localities26 Medicare services in 2024

Medicare pays $643.30 for 63746 nationally in a facility.

Medicare rate · 63746

Shunt removal

Swap in your local Medicare rate.

Work RVUs
7.15
Total RVUs
19.26
Global days
090

National rate · 2026

$643.30

Facility setting, before claim adjustments.

See every locality for 63746 →

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 63746 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 63746 covers

Code 63746 represents operative removal of an implanted shunt that diverts cerebrospinal fluid from the spinal space. A neurosurgeon or other surgeon with relevant expertise typically performs the procedure in an operating room, accessing the implanted catheter and removing the shunt hardware. Removal may be indicated when the device is no longer needed or must be taken out; correcting or replacing an existing shunt points instead toward a revision service.

Report this code when the operative note identifies the spinal shunt and documents its removal, not for placement or revision alone. CMS assigns a 90-day major-surgery global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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 63746 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

63746 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$561.67
Alaska*Unavailable$737.33
ArizonaUnavailable$619.40
ArkansasUnavailable$551.68
AtlantaUnavailable$669.09
AustinUnavailable$649.95
BakersfieldUnavailable$637.71
Baltimore/Surr. CntysUnavailable$693.14
BeaumontUnavailable$608.81
BrazoriaUnavailable$620.36

63746 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
63746 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 63746 rate is calculated

Each of 63746’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 · 63746

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.15Practice expense 9.10Malpractice 3.01

19.2600 adjusted RVUs×$33.4009 conversion factor=$643.30

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

Payment rules and modifiers for 63746

63746 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 63746

Shunt removal

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 63746

Shunt removal

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

63746 without 51 · national facility

$643.30

Shunt removal

63746-51 · Second procedure: 50%

$321.65

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

63746 compared with similar codes

Compare codes

63746 vs 63744 vs 63740 vs 63741: national Medicare rates

Swap in your local Medicare rate.

  • 63746
    Shunt removal · 7.15 wRVU
    —
  • 63744
    Spinal shunt revision · 8.72 wRVU
    —
  • 63740
    Spinal shunt · 12.31 wRVU
    —
  • 63741
    Spinal shunt · 8.89 wRVU
    —

How to choose

63744Spinal shunt revision
Choose 63746 when the shunt is taken out. Choose 63744 when the surgeon revises or replaces the existing shunt.
63740Spinal shunt
63740 describes spinal shunt installation; 63746 describes removal of an implanted spinal shunt.
63741Spinal shunt
63741 is an installation service, whereas 63746 is reported for operative removal of the existing spinal shunt.

Codes related to 63746

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

Codes related to 63746
CodeHow it relatesNational office range
Used instead
63744Spinal shunt revisionFor revision or replacement of an existing spinal shunt rather than removal alone.No office rate
63740Spinal shuntFor spinal shunt installation when a shunt is being placed rather than removed.No office rate
63741Spinal shuntAlso describes spinal shunt installation, not removal of existing hardware.No office rate

63746 billing questions

How does 63746 differ from 63744?

Use 63746 when the spinal shunt is removed. Use 63744 when the surgeon revises or replaces an existing shunt rather than simply taking it out.

Does the 90-day global include postoperative visits?

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

Can modifier 50 be reported?

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

When is an assistant at surgery payable?

CMS payment for an assistant at surgery requires documentation of medical necessity.

How are other same-session procedures paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can co-surgeons or a surgical team be reported?

CMS does not permit co-surgeon or team-surgery payment for this code.

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 63746PPRRVU2026_Oct_nonQPP.csv, line 7,095 (RVU26D)

Open CMS sourceHow we calculate rates

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