No office rate
Both address spinal dural or CSF leakage. Choose 63709 when laminectomy is required for access; 63707 describes repair without that requirement.
On this page
CMS RVU26D · Effective 2026-10-01
63709 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1051.79
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Neurosurgery
About 63709: Spinal dural leak repair with laminectomy
Repair a spinal dural or cerebrospinal fluid leak when a laminectomy is required to expose and close the defect.
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.
CMS billing rules for 63709
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.26 · 47%
- Practice expense (office) RVU11.99 · 37%
- Malpractice RVU5.23 · 16%
697
Medicare services in 2024 · #3265 by national volume
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.
63709 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
63710 describes a spinal dural graft procedure. 63709 describes repair of a leaking dural defect requiring laminectomy; report graft work only when separately supported.
No office rate
63700 is for spinal meningocele repair, not repair of a spinal dural or CSF leak requiring laminectomy.
The same code, a different location
How does El Centro compare?
63709 across payment areas
Same release and payment basis · bars start at $0
El Centro · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Modesto
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Napa
California · 63709
Office
Unavailable
Facility
$1158.38
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 63709
Office
Unavailable
Facility
$1106.16
No comparable office rate is available.
Redding
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Rest Of California
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 63709
Office
Unavailable
Facility
$1106.80
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 63709
Office
Unavailable
Facility
$1087.43
No comparable office rate is available.
Salinas
California · 63709
Office
Unavailable
Facility
$1083.28
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 63709
Office
Unavailable
Facility
$1098.64
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 63709
Office
Unavailable
Facility
$1202.97
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 63709
Office
Unavailable
Facility
$1197.03
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 63709
Office
Unavailable
Facility
$1236.88
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 63709
Office
Unavailable
Facility
$1212.60
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 63709
Office
Unavailable
Facility
$1068.14
No comparable office rate is available.
Santa Cruz-Watsonville
California · 63709
Office
Unavailable
Facility
$1100.61
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 63709
Office
Unavailable
Facility
$1084.56
No comparable office rate is available.
Santa Rosa-Petaluma
California · 63709
Office
Unavailable
Facility
$1110.41
No comparable office rate is available.
Stockton
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Vallejo
California · 63709
Office
Unavailable
Facility
$1149.82
No comparable office rate is available.
Visalia
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Yuba City
California · 63709
Office
Unavailable
Facility
$1050.92
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 63709
Office
Unavailable
Facility
$1203.41
No comparable office rate is available.
Miami
Florida · 63709
Office
Unavailable
Facility
$1368.38
No comparable office rate is available.
Chicago
Illinois · 63709
Office
Unavailable
Facility
$1316.65
No comparable office rate is available.
Manhattan
New York · 63709
Office
Unavailable
Facility
$1284.73
No comparable office rate is available.
Alaska*
Alaska · 63709
Office
Unavailable
Facility
$1287.31
No comparable office rate is available.
Alabama
Alabama · 63709
Office
Unavailable
Facility
$958.99
No comparable office rate is available.
Arkansas
Arkansas · 63709
Office
Unavailable
Facility
$943.67
No comparable office rate is available.
Arizona
Arizona · 63709
Office
Unavailable
Facility
$1047.29
No comparable office rate is available.
Colorado
Colorado · 63709
Office
Unavailable
Facility
$1078.35
No comparable office rate is available.
Connecticut
Connecticut · 63709
Office
Unavailable
Facility
$1162.58
No comparable office rate is available.
Delaware
Delaware · 63709
Office
Unavailable
Facility
$1064.96
No comparable office rate is available.
Fort Lauderdale
Florida · 63709
Office
Unavailable
Facility
$1231.21
No comparable office rate is available.
Rest Of Florida
Florida · 63709
Office
Unavailable
Facility
$1155.11
No comparable office rate is available.
Atlanta
Georgia · 63709
Office
Unavailable
Facility
$1127.91
No comparable office rate is available.
Rest Of Georgia
Georgia · 63709
Office
Unavailable
Facility
$1075.15
No comparable office rate is available.
Hawaii, Guam
Hawaii · 63709
Office
Unavailable
Facility
$1066.18
No comparable office rate is available.
Iowa
Iowa · 63709
Office
Unavailable
Facility
$945.48
No comparable office rate is available.
Idaho
Idaho · 63709
Office
Unavailable
Facility
$960.76
No comparable office rate is available.
East St. Louis
Illinois · 63709
Office
Unavailable
Facility
$1229.96
No comparable office rate is available.
Rest Of Illinois
Illinois · 63709
Office
Unavailable
Facility
$1148.37
No comparable office rate is available.
Suburban Chicago
Illinois · 63709
Office
Unavailable
Facility
$1234.10
No comparable office rate is available.
Indiana
Indiana · 63709
Office
Unavailable
Facility
$965.84
No comparable office rate is available.
Kansas
Kansas · 63709
Office
Unavailable
Facility
$959.77
No comparable office rate is available.
Kentucky
Kentucky · 63709
Office
Unavailable
Facility
$1025.56
No comparable office rate is available.
New Orleans
Louisiana · 63709
Office
Unavailable
Facility
$1084.99
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 63709
Office
Unavailable
Facility
$1031.47
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 63709
Office
Unavailable
Facility
$1164.24
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 63709
Office
Unavailable
Facility
$1078.78
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 63709
Office
Unavailable
Facility
$1163.65
No comparable office rate is available.
Rest Of Maryland
Maryland · 63709
Office
Unavailable
Facility
$1080.44
No comparable office rate is available.
Rest Of Maine
Maine · 63709
Office
Unavailable
Facility
$986.79
No comparable office rate is available.
Southern Maine
Maine · 63709
Office
Unavailable
Facility
$1016.80
No comparable office rate is available.
Detroit
Michigan · 63709
Office
Unavailable
Facility
$1190.68
No comparable office rate is available.
Rest Of Michigan
Michigan · 63709
Office
Unavailable
Facility
$1072.55
No comparable office rate is available.
Minnesota
Minnesota · 63709
Office
Unavailable
Facility
$973.50
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 63709
Office
Unavailable
Facility
$1056.41
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 63709
Office
Unavailable
Facility
$1065.99
No comparable office rate is available.
Rest Of Missouri
Missouri · 63709
Office
Unavailable
Facility
$1025.05
No comparable office rate is available.
Mississippi
Mississippi · 63709
Office
Unavailable
Facility
$983.60
No comparable office rate is available.
Montana**
Montana · 63709
Office
Unavailable
Facility
$1084.51
No comparable office rate is available.
North Carolina
North Carolina · 63709
Office
Unavailable
Facility
$994.97
No comparable office rate is available.
North Dakota**
North Dakota · 63709
Office
Unavailable
Facility
$981.10
No comparable office rate is available.
Nebraska
Nebraska · 63709
Office
Unavailable
Facility
$945.37
No comparable office rate is available.
New Hampshire
New Hampshire · 63709
Office
Unavailable
Facility
$1079.44
No comparable office rate is available.
Northern Nj
New Jersey · 63709
Office
Unavailable
Facility
$1192.93
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 63709
Office
Unavailable
Facility
$1159.04
No comparable office rate is available.
New Mexico
New Mexico · 63709
Office
Unavailable
Facility
$1086.73
No comparable office rate is available.
Nevada**
Nevada · 63709
Office
Unavailable
Facility
$1056.09
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 63709
Office
Unavailable
Facility
$1342.88
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 63709
Office
Unavailable
Facility
$1182.53
No comparable office rate is available.
Queens
New York · 63709
Office
Unavailable
Facility
$1267.58
No comparable office rate is available.
Rest Of New York
New York · 63709
Office
Unavailable
Facility
$1012.96
No comparable office rate is available.
Ohio
Ohio · 63709
Office
Unavailable
Facility
$1051.42
No comparable office rate is available.
Oklahoma
Oklahoma · 63709
Office
Unavailable
Facility
$1003.06
No comparable office rate is available.
Portland
Oregon · 63709
Office
Unavailable
Facility
$1092.75
No comparable office rate is available.
Rest Of Oregon
Oregon · 63709
Office
Unavailable
Facility
$1031.38
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 63709
Office
Unavailable
Facility
$1144.17
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 63709
Office
Unavailable
Facility
$1042.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 63709
Office
Unavailable
Facility
$1086.65
No comparable office rate is available.
Rhode Island
Rhode Island · 63709
Office
Unavailable
Facility
$1088.90
No comparable office rate is available.
South Carolina
South Carolina · 63709
Office
Unavailable
Facility
$1028.22
No comparable office rate is available.
South Dakota**
South Dakota · 63709
Office
Unavailable
Facility
$968.87
No comparable office rate is available.
Tennessee
Tennessee · 63709
Office
Unavailable
Facility
$967.54
No comparable office rate is available.
Austin
Texas · 63709
Office
Unavailable
Facility
$1089.19
No comparable office rate is available.
Beaumont
Texas · 63709
Office
Unavailable
Facility
$1036.42
No comparable office rate is available.
Brazoria
Texas · 63709
Office
Unavailable
Facility
$1046.90
No comparable office rate is available.
Dallas
Texas · 63709
Office
Unavailable
Facility
$1063.04
No comparable office rate is available.
Fort Worth
Texas · 63709
Office
Unavailable
Facility
$1061.31
No comparable office rate is available.
Galveston
Texas · 63709
Office
Unavailable
Facility
$1056.09
No comparable office rate is available.
Houston
Texas · 63709
Office
Unavailable
Facility
$1151.82
No comparable office rate is available.
Rest Of Texas
Texas · 63709
Office
Unavailable
Facility
$1047.49
No comparable office rate is available.
Utah
Utah · 63709
Office
Unavailable
Facility
$1043.01
No comparable office rate is available.
Virginia
Virginia · 63709
Office
Unavailable
Facility
$1026.70
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 63709
Office
Unavailable
Facility
$1086.65
No comparable office rate is available.
Vermont
Vermont · 63709
Office
Unavailable
Facility
$994.56
No comparable office rate is available.
Rest Of Washington
Washington · 63709
Office
Unavailable
Facility
$1070.96
No comparable office rate is available.
Seattle (King Cnty)
Washington · 63709
Office
Unavailable
Facility
$1169.29
No comparable office rate is available.
Wisconsin
Wisconsin · 63709
Office
Unavailable
Facility
$947.16
No comparable office rate is available.
West Virginia
West Virginia · 63709
Office
Unavailable
Facility
$1107.69
No comparable office rate is available.
Wyoming**
Wyoming · 63709
Office
Unavailable
Facility
$1039.44
No comparable office rate is available.
See how rates vary across the country
63709 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 63709 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1156.97
$1051.79 × 110% = $1156.97
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 63709 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
7,090
- Code
- 63709
- Physician work
- 15.26
- Practice expense
- 11.99
- Malpractice
- 5.23
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.26 | × 1.017 | 15.5194 |
| Practice expense | 11.99 | × 1.096 | 13.1410 |
| Malpractice | 5.23 | × 0.541 | 2.8294 |
| Total RVUs | 31.4899 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$1051.79
Open 63709 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.26 | 1.017 |
| Practice expense | 11.99 | 1.096 |
| Malpractice | 5.23 | 0.541 |
(15.26 × 1.017 + 11.99 × 1.096 + 5.23 × 0.541) × $33.4009 = $1051.79
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
63709 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1051.79 | RVU26D |
| 2026-07-01 | Not available in this setting | $1051.79 | RVU26C |
| 2026-04-01 | Not available in this setting | $1051.79 | RVU26B |
| 2026-01-01 | Not available in this setting | $1051.79 | RVU26A |
| 2025-10-01 | Not available in this setting | $1080.86 | RVU25D |
| 2025-07-01 | Not available in this setting | $1080.86 | RVU25C |
| 2025-04-01 | Not available in this setting | $1080.86 | RVU25B |
| 2025-01-01 | Not available in this setting | $1080.86 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,08763704,,Repair of spinal herniation,A,,21.87,18.91,NA,18.91,,9.23,50.01,50.01,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08863706,,Repair of spinal herniation,A,,24.72,19.91,NA,19.91,,10.44,55.07,55.07,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08963707,,Repair spinal fluid leakage,A,,12.33,11.11,NA,11.11,,4.34,27.78,27.78,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09063709,,Repair spinal fluid leakage,A,,15.26,11.99,NA,11.99,,5.23,32.48,32.48,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09163710,,Graft repair of spine defect,A,,15.02,11.63,NA,11.63,,4.66,31.31,31.31,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09263740,,Install spinal shunt,A,,12.31,12.73,NA,12.73,,5.17,30.21,30.21,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09363741,,Install spinal shunt,A,,8.89,9.11,NA,9.11,,3.35,21.35,21.35,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664