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CMS RVU26D · Effective 2026-10-01

63704 Spinal defect repair Medicare reimbursement rates in Arkansas

Reports operative repair of a newborn’s myelomeningocele, a congenital spinal defect involving herniated neural tissue and its coverings. Compare 63704 office and facility rates across CMS payment localities in Arkansas.

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.

What does Medicare pay for 63704 in Arkansas?

Arkansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1431.80

1 of 1 localities have a supported rate.

Payment area: Arkansas

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 63704 in your payment locality →

Neurosurgery

About 63704: Newborn myelomeningocele repair

Reports operative repair of a newborn’s myelomeningocele, a congenital spinal defect involving herniated neural tissue and its coverings.

This code is for surgical repair of a myelomeningocele in a newborn. A neurosurgeon typically performs the operation in a hospital operating room to close the congenital spinal defect and address the exposed or herniated neural elements and coverings. It is distinct from repair of a meningocele and from surgery for a cerebrospinal fluid leak.

Choose the newborn category based on the patient and the documented myelomeningocele diagnosis; the operative report should describe the defect and the repair performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 63704

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 RVU21.87 · 44%
  • Practice expense (office) RVU18.91 · 38%
  • Malpractice RVU9.23 · 18%

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.

63704 compared with similar codes

Office rates for Arkansas, from the same CMS release.

63706

Spinal defect repair

Except newborn

No office rate

63704 is the newborn myelomeningocele repair category; 63706 is used for the infant category. Confirm the patient category and operative documentation.

63700

Meningocele repair

Patient younger than one year

No office rate

63700 concerns meningocele repair in the smaller lesion-size category. It is not the newborn myelomeningocele repair code.

63702

Spinal repair

Meningocele, not newborn

No office rate

63702 concerns meningocele repair in the larger lesion-size category. It does not describe newborn myelomeningocele repair.

63707

Spinal leak repair

Without laminectomy

No office rate

63707 addresses repair of a spinal fluid leak, not repair of a newborn’s myelomeningocele.

Compare 63704 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 63704 in Arkansas.

PPRRVU2026_Oct_nonQPP.csv

7,087

Code
63704
Physician work
21.87
Practice expense
18.91
Malpractice
9.23

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Facility calculation for 63704 in Arkansas
ComponentRVULocality factorAdjusted
Physician work21.87× 1.00021.8700
Practice expense18.91× 0.85916.2437
Malpractice9.23× 0.5154.7534
Total RVUs42.8671
Conversion factor× 33.4009

Facility rate, Arkansas$1431.80

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work21.871
Practice expense18.910.859
Malpractice9.230.515

(21.87 × 1 + 18.91 × 0.859 + 9.23 × 0.515) × $33.4009 = $1431.80

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.

63704 billing questions

How does this code differ from 63706?

Both describe myelomeningocele repair, but 63704 is the newborn category and 63706 is the infant category. Use the category that matches the patient and the documented procedure.

Should this be used for a meningocele repair?

No. Codes 63700 and 63702 describe meningocele repair, with the applicable code determined by the lesion-size distinction in that code family. Code 63704 is for newborn myelomeningocele repair.

Does this code include routine postoperative care?

Yes. Its 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 is not permitted.

Can modifier 50 be used?

No. The descriptor and anatomy make a bilateral adjustment inappropriate.

How is this procedure handled with other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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.

RVUs for 63704PPRRVU2026_Oct_nonQPP.csv, line 7,087 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)