No office rate
Both use an autograft for skull reconstruction. The defect-size distinction is 5 cm or smaller for 62146 versus larger than 5 cm for 62147.
On this page
CMS RVU26D · Effective 2026-10-01
62147 Cranioplasty Medicare reimbursement rates in Connecticut
Reports surgical reconstruction of a skull defect larger than 5 cm using the patient's own bone graft, commonly after trauma or craniectomy. Compare 62147 office and facility rates across CMS payment localities in Connecticut.
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 62147 in Connecticut?
Connecticut 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
$1463.84
1 of 1 localities have a supported rate.
Payment area: Connecticut
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.
Neurosurgery
About 62147: Large skull defect reconstruction with autograft
Reports surgical reconstruction of a skull defect larger than 5 cm using the patient's own bone graft, commonly after trauma or craniectomy.
This service reconstructs a skull defect larger than 5 cm using the patient’s own bone as graft material. Neurosurgeons typically perform it in an operating room to restore cranial protection and contour after decompressive craniectomy, traumatic bone loss, or prior skull surgery. The reconstruction is distinct from simply removing or replacing an existing bone flap or prosthetic plate.
Select this code when the operative report supports both the defect size and use of an autograft. Document the defect dimensions, graft source, and reconstruction performed; a smaller defect or a large reconstruction without an autograft points to a different code. Medicare treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.
CMS billing rules for 62147
- 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 RVU20.15 · 49%
- Practice expense (office) RVU12.79 · 31%
- Malpractice RVU7.85 · 19%
102
Medicare services in 2024 · #4870 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.
62147 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
This code is for a defect larger than 5 cm reconstructed without the autograft feature of 62147.
No office rate
62143 addresses replacement of a bone flap or prosthetic plate; 62147 describes reconstruction using the patient’s own bone graft.
No office rate
62142 is for removal of a bone flap or prosthetic plate, not reconstruction of a large skull defect with an autograft.
Compare 62147 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$1463.84
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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 62147 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
6,921
- Code
- 62147
- Physician work
- 20.15
- Practice expense
- 12.79
- Malpractice
- 7.85
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.15 | × 1.020 | 20.5530 |
| Practice expense | 12.79 | × 1.077 | 13.7748 |
| Malpractice | 7.85 | × 1.210 | 9.4985 |
| Total RVUs | 43.8263 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$1463.84
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.15 | 1.02 |
| Practice expense | 12.79 | 1.077 |
| Malpractice | 7.85 | 1.21 |
(20.15 × 1.02 + 12.79 × 1.077 + 7.85 × 1.21) × $33.4009 = $1463.84
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.
62147 billing questions
How does this differ from 62146?
Both describe skull-defect reconstruction using an autograft. Use 62147 for a defect larger than 5 cm and 62146 for a defect 5 cm or smaller.
When would 62141 be more appropriate?
62141 describes reconstruction of a skull defect larger than 5 cm without the autograft feature specified by 62147. The operative report should support which reconstruction method was performed.
Does the 90-day global include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
How are assistants and co-surgeons handled?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery 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.
6,91862143,,Rpl b1 flp/prostc plate skl,A,,13.80,11.79,NA,11.79,,5.63,31.22,31.22,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91962145,,Repair of skull & brain,A,,19.59,13.57,NA,13.57,,7.74,40.90,40.90,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,92062146,,Crnop w/autograft<5 cm diam,A,,16.85,13.27,NA,13.27,,7.10,37.22,37.22,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,92162147,,Crnop w/autograft>5 cm diam,A,,20.15,12.79,NA,12.79,,7.85,40.79,40.79,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,92262148,,Retr bone flap to fix skull,A,,1.95,0.68,NA,0.68,,0.82,3.45,3.45,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,92362160,,Neuroendoscopy add-on,A,,2.93,1.02,NA,1.02,,1.21,5.16,5.16,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,92462161,,Dissect brain w/scope,A,,20.70,15.65,NA,15.65,,8.64,44.99,44.99,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808