Billing code 63709: CSF leak repairMedicare rate & RVUs in Washington
Repair a spinal dural or cerebrospinal fluid leak when a laminectomy is required to expose and close the defect.
CMS doesn’t publish an office rate for 63709 in Washington.
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 63709 covers
This code describes operative repair of a spinal dural defect that is leaking cerebrospinal fluid and requires a laminectomy for access. A neurosurgeon or spine surgeon may perform it in a hospital operating room for a leak identified during or after spinal surgery, or for another documented spinal dural defect. The operative work centers on exposing the leak through the required bony removal and repairing the defect to stop fluid escape.
Select this code when the operative report supports both the CSF leak repair and the need for a laminectomy to reach it; a leak repair performed without laminectomy is represented by 63707. The report should identify the defect, leakage, surgical exposure, and repair performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 63709 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,070.96 |
| Seattle (King Cnty) | Unavailable | $1,169.29 |
How the 63709 rate is calculated
Each of 63709’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 · 63709
RVUs × geographic indexes × conversion factor
Work15.26
15.26 RVUs× 1.000 GPCI
Practice expense11.99
11.99 RVUs× 1.000 GPCI
Malpractice5.23
5.23 RVUs× 1.000 GPCI
Adjusted RVUs
32.4800
Conversion factor
$33.4009
Medicare rate
$1,084.86
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 63709
63709 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 63709
CSF leak 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 · 63709
CSF leak 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
63709 without 51 · national facility
$1,084.86
CSF leak repair
63709-51 · Second procedure: 50%
$542.43
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%).
63709 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 63707Spinal leak repair
- Both address spinal dural or CSF leakage. Choose 63709 when laminectomy is required for access; 63707 describes repair without that requirement.
- 63710Dural repair
- 63710 describes a spinal dural graft procedure. 63709 describes repair of a leaking dural defect requiring laminectomy; report graft work only when separately supported.
- 63700Meningocele repair
- 63700 is for spinal meningocele repair, not repair of a spinal dural or CSF leak requiring laminectomy.
63709 billing questions
How is 63709 different from 63707?
63709 is for repair of a spinal dural or CSF leak requiring laminectomy for access. Use 63707 when the leak repair does not require laminectomy.
What documentation supports reporting 63709?
The operative report should describe the spinal dural defect and CSF leakage, the laminectomy needed to expose it, and the repair performed.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this code's anatomy.
What postoperative care is included?
The 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 payment is not permitted.
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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