62147 Cranioplasty Medicare reimbursement rates in Georgia

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.