Billing code 62120: Encephalocele repairMedicare rate & RVUs in Guam
Repair of an extradural skull-base encephalocele, reported when the surgeon closes the defect and addresses the herniated contents.
CMS doesn’t publish an office rate for 62120 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 62120 covers
This service repairs an encephalocele at the skull base when the repair is extradural. An encephalocele is a protrusion of meninges, sometimes with brain tissue, through a skull defect. Neurosurgeons and skull-base surgeons, including otolaryngologists working with a neurosurgical team, may perform the operation in a hospital operating room. The operative report should identify the skull-base site, the encephalocele, and the extradural nature of the repair.
Choose this code for the extradural repair, not the intradural repair represented by 62121 or a procedure directed only at a cerebrospinal-fluid leak. Documentation should make the pathology and surgical approach clear. Medicare assigns a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and reduces others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
62120 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $2,139.96 |
How the 62120 rate is calculated
Each of 62120’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 62120
RVUs × geographic indexes × conversion factor
Work23.98
23.98 RVUs× 1.000 GPCI
Practice expense30.10
30.10 RVUs× 1.000 GPCI
Malpractice10.13
10.13 RVUs× 1.000 GPCI
Adjusted RVUs
64.2100
Conversion factor
$33.4009
Medicare rate
$2,144.67
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 62120
62120 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 62120
Encephalocele repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 62120
Encephalocele repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
62120 without 51 · national facility
$2,144.67
Encephalocele repair
62120-51 · Second procedure: 50%
$1,072.34
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
62120 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 62121Skull-base repair
- Use 62120 for an extradural skull-base encephalocele repair and 62121 when the repair is intradural.
- 62100Brain fluid leak repair
- 62100 addresses repair for a CSF leak; 62120 is for an extradural skull-base encephalocele.
- 62140Cranioplasty
- 62140 is cranioplasty for a skull defect measuring up to 5 cm, rather than repair of a skull-base encephalocele.
- 62141Cranioplasty
- 62141 is cranioplasty for a skull defect larger than 5 cm; it is not the extradural encephalocele repair described by 62120.
62120 billing questions
How do I distinguish 62120 from 62121?
The distinction is whether the skull-base encephalocele repair is extradural or intradural. The operative report should support the documented plane of repair.
Is this the code for repair of a CSF leak alone?
No. This code describes extradural repair of a skull-base encephalocele. A repair directed at a CSF leak without an encephalocele may point to 62100 instead.
Can I append modifier 50 for repair on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative services are included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 62120 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →