No office rate
Both codes concern myelomeningocele repair. The patient category distinguishes 63704, which is for newborns, from 63706.
On this page
CMS RVU26D · Effective 2026-10-01
63706 Spinal defect repair Medicare reimbursement rates in Pennsylvania
Reports operative repair of a myelomeningocele in a patient outside the newborn category, including closure of the congenital spinal defect. Compare 63706 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 63706 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
$1765.68–$1948.82
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 63706: Myelomeningocele repair, non-newborn
Reports operative repair of a myelomeningocele in a patient outside the newborn category, including closure of the congenital spinal defect.
CPT 63706 covers surgical repair of a myelomeningocele, a congenital spinal defect involving neural tissue and its coverings. A neurosurgeon typically performs the operation in a hospital operating room, addressing the defect and closing the involved tissues. The patient must fall outside the newborn category for this code; the newborn repair is represented by a separate code in the family.
The operative report should identify the myelomeningocele, document the repair performed, and support the patient category used to select the code. CMS assigns a 90-day major-surgery 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. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 63706
- 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 RVU24.72 · 45%
- Practice expense (office) RVU19.91 · 36%
- Malpractice RVU10.44 · 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.
63706 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
63702 describes repair of a meningocele in a patient outside the newborn category; 63706 is for myelomeningocele repair.
No office rate
63707 addresses repair of a spinal fluid leak rather than operative repair of a myelomeningocele.
Compare 63706 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
$1948.82
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1765.68
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63706 billing questions
How is 63706 distinguished from 63704?
Both describe repair of a myelomeningocele. Use 63706 for a patient outside the newborn category; 63704 is the newborn-family code.
How is this different from the meningocele repair codes?
63706 is for a myelomeningocele. Codes 63700 and 63702 are for meningocele repair, with the patient category distinguishing those codes.
Is postoperative care included?
Yes. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
Should modifier 50 be used for a defect involving both sides?
Modifier 50 is inappropriate for this descriptor and anatomy; report the repair under the applicable code without a bilateral adjustment.
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.
7,08563700,,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
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