No office rate
62121 describes repair of a skull-base encephalocele. Code 62100 is directed to repair of a dural or cerebrospinal fluid leak.
On this page
CMS RVU26D · Effective 2026-10-01
62121 Skull-base repair Medicare reimbursement rates in Delaware
Reports open surgical repair of a skull-base encephalocele, where herniated intracranial contents pass through a defect in the skull base. Compare 62121 office and facility rates across CMS payment localities in Delaware.
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 62121 in Delaware?
Delaware 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
$1411.12
1 of 1 localities have a supported rate.
Payment area: Delaware
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 62121: Skull-base encephalocele repair
Reports open surgical repair of a skull-base encephalocele, where herniated intracranial contents pass through a defect in the skull base.
A neurosurgeon repairs a skull-base defect associated with an encephalocele, in which intracranial tissue or its coverings protrude through the skull. The operation uses an open skull approach to address the defect and may include reconstruction needed to complete the repair. These cases are typically performed in a hospital operating room, often with neurosurgery and other surgical specialists involved when the anatomy requires it.
Report 62121 for the documented skull-base encephalocele repair, rather than a general repair of a cerebrospinal fluid leak or reconstruction of a separate skull defect. The operative note should identify the encephalocele, the skull-base defect, and the repair performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 62121
- 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 RVU22.45 · 52%
- Practice expense (office) RVU14.52 · 34%
- Malpractice RVU5.94 · 14%
267
Medicare services in 2024 · #4085 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.
62121 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both concern skull-base encephalocele repair. Use the full CPT descriptors and documented operative details to determine which procedure was performed.
No office rate
62140 is cranioplasty for a skull defect. It is not a substitute for a skull-base encephalocele repair.
Compare 62121 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
Delaware →
Office / nonfacility
Unavailable
Facility
$1411.12
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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 62121 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,914
- Code
- 62121
- Physician work
- 22.45
- Practice expense
- 14.52
- Malpractice
- 5.94
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.45 | × 1.005 | 22.5622 |
| Practice expense | 14.52 | × 0.988 | 14.3458 |
| Malpractice | 5.94 | × 0.899 | 5.3401 |
| Total RVUs | 42.2481 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1411.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.45 | 1.005 |
| Practice expense | 14.52 | 0.988 |
| Malpractice | 5.94 | 0.899 |
(22.45 × 1.005 + 14.52 × 0.988 + 5.94 × 0.899) × $33.4009 = $1411.12
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.
62121 billing questions
When should 62121 be selected instead of 62100?
Use 62121 for repair of a skull-base encephalocele. Code 62100 describes repair of a dural or cerebrospinal fluid leak, so the operative indication and work performed distinguish the services.
How is 62121 distinguished from 62120?
Both codes concern skull-base encephalocele repair. Confirm the specific procedure performed against the full CPT descriptors and operative report before choosing between them.
Can modifier 50 be appended when the repair involves both sides?
No. CMS identifies modifier 50 as inappropriate for this service; report the procedure without a bilateral adjustment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. A separately reportable service must be distinct from that included care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, CMS pays the highest-valued procedure in full and other procedures at 50%.
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.
6,91162115,,Reduction of skull defect,A,,22.34,18.57,NA,18.57,,9.42,50.33,50.33,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91262117,,Reduction of skull defect,A,,27.64,17.73,NA,17.73,,11.70,57.07,57.07,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91362120,,Repair skull cavity lesion,A,,23.98,30.10,NA,30.10,,10.13,64.21,64.21,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91462121,,Incise skull repair,A,,22.45,14.52,NA,14.52,,5.94,42.91,42.91,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91562140,,Crnop skull defect<5 cm diam,A,,14.19,10.22,NA,10.22,,4.90,29.31,29.31,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91662141,,Crnop skull defect>5 cm diam,A,,15.67,11.76,NA,11.76,,5.97,33.40,33.40,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91762142,,Rmvl b1 flp/prostc plate skl,A,,11.53,10.81,NA,10.81,,4.64,26.98,26.98,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503