No office rate
Use 63744 for revision of an existing spinal shunt; 63740 describes installation of a spinal shunt.
On this page
CMS RVU26D · Effective 2026-10-01
63744 Spinal shunt revision Medicare reimbursement rates in Wyoming
Surgical revision of an existing spinal cerebrospinal-fluid shunt is reported when the surgeon corrects a shunt problem rather than placing or removing it. Compare 63744 office and facility rates across CMS payment localities in Wyoming.
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 63744 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$704.28
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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 63744: Revision of spinal cerebrospinal fluid shunt
Surgical revision of an existing spinal cerebrospinal-fluid shunt is reported when the surgeon corrects a shunt problem rather than placing or removing it.
A neurosurgeon revises an existing spinal shunt used to divert cerebrospinal fluid from the spinal subarachnoid space. The operation addresses a problem with the shunt, such as impaired function or displacement, by surgically correcting the existing system. These procedures are generally performed in an operating room; the operative report should identify the shunt and describe the revision performed.
Report 63744 for revision work on an existing shunt, not for initial installation or removal alone. Documentation should state the clinical reason for revision and distinguish the work from placement of a new shunt or simple removal. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 63744
- 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 RVU8.72 · 40%
- Practice expense (office) RVU9.65 · 44%
- Malpractice RVU3.67 · 17%
65
Medicare services in 2024 · #5190 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.
63744 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
63741 is an installation code. Choose 63744 when the operative work revises an existing shunt instead of placing one.
No office rate
63746 represents spinal shunt removal. Use 63744 when the surgeon performs revision work on the existing shunt rather than removal alone.
No office rate
63709 addresses repair of a spinal fluid leak; 63744 is for revision of a spinal shunt.
Compare 63744 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$704.28
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 63744 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,094
- Code
- 63744
- Physician work
- 8.72
- Practice expense
- 9.65
- Malpractice
- 3.67
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.72 | × 1.000 | 8.7200 |
| Practice expense | 9.65 | × 1.000 | 9.6500 |
| Malpractice | 3.67 | × 0.740 | 2.7158 |
| Total RVUs | 21.0858 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$704.28
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.72 | 1 |
| Practice expense | 9.65 | 1 |
| Malpractice | 3.67 | 0.74 |
(8.72 × 1 + 9.65 × 1 + 3.67 × 0.74) × $33.4009 = $704.28
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
63744 billing questions
When should 63744 be used instead of a spinal shunt insertion code?
Use 63744 when the surgeon revises an already existing spinal shunt. Initial installation is reported with the applicable insertion code, such as 63740 or 63741.
Is 63744 reported for removing a spinal shunt?
No. Removal alone is distinguished from revision and is reported with 63746. The operative report should make clear whether the surgeon revised the shunt or removed it.
What documentation supports 63744?
Document the existing spinal shunt, the reason for surgery, and the specific revision work performed. This helps distinguish revision from new placement or removal alone.
Should modifier 50 be appended for revision of paired shunts?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy; modifier 50 should not be used.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, while team surgery 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 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.
7,09163710,,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
7,09263740,,Install spinal shunt,A,,12.31,12.73,NA,12.73,,5.17,30.21,30.21,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09363741,,Install spinal shunt,A,,8.89,9.11,NA,9.11,,3.35,21.35,21.35,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09463744,,Revision of spinal shunt,A,,8.72,9.65,NA,9.65,,3.67,22.04,22.04,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09563746,,Removal of spinal shunt,A,,7.15,9.10,NA,9.10,,3.01,19.26,19.26,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09664400,,Njx aa&/strd trigeminal nrv,A,,0.73,2.71,,0.48,,0.21,3.65,1.42,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,09764405,,Njx aa&/strd gr ocpl nrv,A,,0.92,1.23,,0.25,,0.21,2.36,1.38,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,