No office rate
Both address spinal dural or CSF leakage. Choose 63709 when laminectomy is required for access; 63707 describes repair without that requirement.
On this page
CMS RVU26D · Effective 2026-10-01
63709 CSF leak repair Medicare reimbursement rates in Massachusetts
Repair a spinal dural or cerebrospinal fluid leak when a laminectomy is required to expose and close the defect. Compare 63709 office and facility rates across CMS payment localities in Massachusetts.
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 63709 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1078.78–$1164.24
2 of 2 localities have a supported rate.
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 63709: Spinal dural leak repair with laminectomy
Repair a spinal dural or cerebrospinal fluid leak when a laminectomy is required to expose and close the defect.
This code describes operative repair of a spinal dural defect that is leaking cerebrospinal fluid and requires a laminectomy for access. A neurosurgeon or spine surgeon may perform it in a hospital operating room for a leak identified during or after spinal surgery, or for another documented spinal dural defect. The operative work centers on exposing the leak through the required bony removal and repairing the defect to stop fluid escape.
Select this code when the operative report supports both the CSF leak repair and the need for a laminectomy to reach it; a leak repair performed without laminectomy is represented by 63707. The report should identify the defect, leakage, surgical exposure, and repair performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 63709
- 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 RVU15.26 · 47%
- Practice expense (office) RVU11.99 · 37%
- Malpractice RVU5.23 · 16%
697
Medicare services in 2024 · #3265 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.
63709 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
63710 describes a spinal dural graft procedure. 63709 describes repair of a leaking dural defect requiring laminectomy; report graft work only when separately supported.
No office rate
63700 is for spinal meningocele repair, not repair of a spinal dural or CSF leak requiring laminectomy.
Compare 63709 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$1164.24
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$1078.78
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63709 billing questions
How is 63709 different from 63707?
63709 is for repair of a spinal dural or CSF leak requiring laminectomy for access. Use 63707 when the leak repair does not require laminectomy.
What documentation supports reporting 63709?
The operative report should describe the spinal dural defect and CSF leakage, the laminectomy needed to expose it, and the repair performed.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this code's anatomy.
What postoperative care is included?
The 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 payment 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.
7,08763704,,Repair of spinal herniation,A,,21.87,18.91,NA,18.91,,9.23,50.01,50.01,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08863706,,Repair of spinal herniation,A,,24.72,19.91,NA,19.91,,10.44,55.07,55.07,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08963707,,Repair spinal fluid leakage,A,,12.33,11.11,NA,11.11,,4.34,27.78,27.78,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09063709,,Repair spinal fluid leakage,A,,15.26,11.99,NA,11.99,,5.23,32.48,32.48,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09163710,,Graft repair of spine defect,A,,15.02,11.63,NA,11.63,,4.66,31.31,31.31,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09263740,,Install spinal shunt,A,,12.31,12.73,NA,12.73,,5.17,30.21,30.21,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09363741,,Install spinal shunt,A,,8.89,9.11,NA,9.11,,3.35,21.35,21.35,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00