No office rate
62000 is for a simple depressed skull fracture. Choose 62005 when the fracture has compound or comminuted features.
On this page
CMS RVU26D · Effective 2026-10-01
62005 Skull fracture repair Medicare reimbursement rates in Pennsylvania
Reports operative elevation of a depressed compound or comminuted skull fracture when the treatment is extradural and does not require intracranial exploration. Compare 62005 office and facility rates across CMS payment localities in Pennsylvania.
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 62005 in Pennsylvania?
Pennsylvania 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
$1213.57–$1339.01
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 62005: Elevation of compound depressed skull fracture
Reports operative elevation of a depressed compound or comminuted skull fracture when the treatment is extradural and does not require intracranial exploration.
A neurosurgeon typically reports this service for operative elevation of a depressed skull fracture with compound or comminuted features, when the work is extradural. The procedure is generally performed in an operating room, often after traumatic head injury. The operative note should establish the fracture pattern and describe the elevation and extent of the work, including whether treatment remained extradural.
Choose this code for the compound or comminuted fracture pattern; a simple depressed fracture is represented by 62000, while treatment requiring intracranial exploration or dural repair points to 62010. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 62005
- 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 RVU17.19 · 45%
- Practice expense (office) RVU13.38 · 35%
- Malpractice RVU7.26 · 19%
15
Medicare services in 2024 · #6080 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.
62005 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
62010 describes more extensive skull-fracture treatment requiring intracranial exploration or dural repair; 62005 is for extradural elevation.
No office rate
61312 is for operative evacuation of a supratentorial extradural or subdural hematoma, not elevation of the skull fracture itself.
Compare 62005 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 Philadelphia →
Office / nonfacility
Unavailable
Facility
$1339.01
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1213.57
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62005 billing questions
How does this differ from 62000?
62005 is for a depressed fracture with compound or comminuted features. Use 62000 for the simple fracture pattern.
When is 62010 a better fit?
Use 62010 when the treatment requires intracranial exploration or dural repair, rather than extradural elevation alone.
Can the assistant surgeon be reported?
CMS permits payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What does the global period include?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Should modifier 50 be appended for fractures on both sides?
No. Modifier 50 is inappropriate for this service; report the operative treatment rather than treating it as a bilateral procedure.
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.
6,90561891,,Rev/rplcmt sk-mnt crnl nstm,A,,10.97,9.84,NA,9.84,,4.26,25.07,25.07,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,90661892,,Rmv sk-mnt crnl nstm pg/rcvr,A,,14.63,12.03,NA,12.03,,6.16,32.82,32.82,0,090,0.11,0.76,0.13,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,90762000,,Treat skull fracture,A,,13.58,11.86,NA,11.86,,5.72,31.16,31.16,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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