Billing code 63704: Spinal defect repairMedicare rate & RVUs in Texas
Reports operative repair of a newborn’s myelomeningocele, a congenital spinal defect involving herniated neural tissue and its coverings.
CMS doesn’t publish an office rate for 63704 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 63704 covers
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.
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.
Where 63704 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,673.33 |
| Beaumont | Unavailable | $1,591.65 |
| Brazoria | Unavailable | $1,602.71 |
| Dallas | Unavailable | $1,630.65 |
| Fort Worth | Unavailable | $1,628.34 |
| Galveston | Unavailable | $1,618.78 |
| Houston | Unavailable | $1,787.72 |
| Rest Of Texas | Unavailable | $1,608.26 |
How the 63704 rate is calculated
Each of 63704’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 63704
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.87Practice expense 18.91Malpractice 9.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 63704
63704 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63704
Spinal defect repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 63704
Spinal defect repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
63704 without 51 · national facility
$1,670.38
Spinal defect repair
63704-51 · Second procedure: 50%
$835.19
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
63704 compared with similar codes
Compare codes
63704 vs 63706 vs 63700 vs 63702 vs 63707: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 63706Spinal defect repair
- 63704 is the newborn myelomeningocele repair category; 63706 is used for the infant category. Confirm the patient category and operative documentation.
- 63700Meningocele repair
- 63700 concerns meningocele repair in the smaller lesion-size category. It is not the newborn myelomeningocele repair code.
- 63702Spinal repair
- 63702 concerns meningocele repair in the larger lesion-size category. It does not describe newborn myelomeningocele repair.
- 63707Spinal leak repair
- 63707 addresses repair of a spinal fluid leak, not repair of a newborn’s myelomeningocele.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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