No office rate
62140 addresses cranioplasty for a skull defect smaller than 5 cm. It is not the single-suture craniosynostosis procedure reported with 62115.
On this page
CMS RVU26D · Effective 2026-10-01
62115 Craniosynostosis surgery Medicare reimbursement rates in New Jersey
Reports surgical correction of craniosynostosis involving one cranial suture by removing and reshaping bone to address abnormal skull growth. Compare 62115 office and facility rates across CMS payment localities in New Jersey.
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 62115 in New Jersey?
New Jersey 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
$1798.50–$1848.71
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 62115: Single-suture craniosynostosis craniectomy
Reports surgical correction of craniosynostosis involving one cranial suture by removing and reshaping bone to address abnormal skull growth.
This operation treats craniosynostosis, in which a cranial suture closes prematurely and restricts normal skull growth. The surgeon removes and reshapes bone around the affected suture to improve skull shape and allow room for growth. It is typically performed by a neurosurgeon or craniofacial surgeon in a hospital operating room, often as part of a coordinated pediatric craniofacial care plan. The key distinction is correction involving a single cranial suture, rather than a multiple-suture procedure or repair of a separate skull defect.
Report the code when the operative documentation supports treatment of single-suture craniosynostosis and describes the involved suture and the bone work performed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate for this anatomy and procedure.
CMS billing rules for 62115
- 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 RVU22.34 · 44%
- Practice expense (office) RVU18.57 · 37%
- Malpractice RVU9.42 · 19%
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.
62115 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
62141 addresses cranioplasty for a skull defect larger than 5 cm; 62115 instead describes correction of single-suture craniosynostosis.
Compare 62115 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$1848.71
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$1798.50
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62115 billing questions
How do I distinguish this from 62116?
This code is for craniosynostosis involving one cranial suture. Use 62116 when the operation addresses multiple cranial sutures.
Is this the same as a cranioplasty for a skull defect?
No. This code addresses craniosynostosis involving a single suture. Codes such as 62140 and 62141 describe cranioplasty for a skull defect and use defect size to distinguish the service.
What documentation supports reporting this code?
Document the diagnosis of craniosynostosis, the single suture involved, and the operative bone removal and reshaping performed.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this procedure and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through the 90 days after surgery.
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.
6,90862005,,Treat skull fracture,A,,17.19,13.38,NA,13.38,,7.26,37.83,37.83,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,90962010,,Treatment of head injury,A,,20.89,15.74,NA,15.74,,8.81,45.44,45.44,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91062100,,Repair brain fluid leakage,A,,22.94,13.23,NA,13.23,,7.43,43.60,43.60,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,91162115,,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