No office rate
63704 is the newborn myelomeningocele repair category; 63706 is used for the infant category. Confirm the patient category and operative documentation.
On this page
CMS RVU26D · Effective 2026-10-01
63704 Spinal defect repair Medicare reimbursement rates in Michigan
Reports operative repair of a newborn’s myelomeningocele, a congenital spinal defect involving herniated neural tissue and its coverings. Compare 63704 office and facility rates across CMS payment localities in Michigan.
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 63704 in Michigan?
Michigan 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
$1655.20–$1859.76
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 63704: Newborn myelomeningocele repair
Reports operative repair of a newborn’s myelomeningocele, a congenital spinal defect involving herniated neural tissue and its coverings.
This code is for surgical repair of a myelomeningocele in a newborn. A neurosurgeon typically performs the operation in a hospital operating room to close the congenital spinal defect and address the exposed or herniated neural elements and coverings. It is distinct from repair of a meningocele and from surgery for a cerebrospinal fluid leak.
Choose the newborn category based on the patient and the documented myelomeningocele diagnosis; the operative report should describe the defect and the repair performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63704
- 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 RVU21.87 · 44%
- Practice expense (office) RVU18.91 · 38%
- Malpractice RVU9.23 · 18%
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.
63704 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
63700 concerns meningocele repair in the smaller lesion-size category. It is not the newborn myelomeningocele repair code.
No office rate
63702 concerns meningocele repair in the larger lesion-size category. It does not describe newborn myelomeningocele repair.
No office rate
63707 addresses repair of a spinal fluid leak, not repair of a newborn’s myelomeningocele.
Compare 63704 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
Detroit →
Office / nonfacility
Unavailable
Facility
$1859.76
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1655.20
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63704 billing questions
How does this code differ from 63706?
Both describe myelomeningocele repair, but 63704 is the newborn category and 63706 is the infant category. Use the category that matches the patient and the documented procedure.
Should this be used for a meningocele repair?
No. Codes 63700 and 63702 describe meningocele repair, with the applicable code determined by the lesion-size distinction in that code family. Code 63704 is for newborn myelomeningocele repair.
Does this code include routine postoperative care?
Yes. Its 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 is not permitted.
Can modifier 50 be used?
No. The descriptor and anatomy make a bilateral adjustment inappropriate.
How is this procedure handled with other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
7,08463688,,Rev/rmv imp sp npg/r dtch cn,A,,4.24,3.85,NA,3.85,,1.06,9.15,9.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08563700,,Repair of spinal herniation,A,,17.03,15.40,NA,15.40,,7.19,39.62,39.62,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08663702,,Repair of spinal herniation,A,,18.92,16.06,NA,16.06,,7.98,42.96,42.96,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,08763704,,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