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See a sample rate comparisonCPT 63704 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Myelomeningocele; Under 5 Cm Diam
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 62 - Co-Surgeons 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63704 |
| Medicaid Fee Schedule | View Medicaid rates for 63704 |
National average reimbursement for CPT 63704 by major payers:
$2,043.76
$2,211.99
$2,262.66
$2,635.11
Compare published rates across providers.
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CPT 63704
5 of 25 sample ratesHigher to lower in this preview
Performance Health Surgicenter, LLC
Performance Health Surgicenter LLC
$2,732.00Published rateOro Valley Surgical Suites LLC
Oro Valley Surgical Suites, LLC
$1,049.00Published rateBellingham Ear Nose Throat And Facial Surgery Inc, Whatcom Surgery Center
Bellingham Ear, Nose, Throat & Facial Plastic Surgery, Inc. P.S.
$560.00Published rateNorthwest Florida Surgical Center, LLC, North Florida Surgery Center
Northwest Florida Surgical Center
$372.00Published rateAmbulatory Surgery Center Of Tucson, Inc.
Ambulatory Surgery Center Of Tucson Inc
$100.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 63704 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63704 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 63704 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 63700-CPT | High | Repair Meningocele; Less Than 5 Cm. Diam |
| 63704-CPT | High | Repair Myelomeningocele; Under 5 Cm Diam |
| 63706-CPT | High | Repair Myelomeningocele >5cm |
| 63709-CPT | High | Rpair Of Dural/Cerebrospinal Fluid Leak Or Pseudomeningoce W/ La, Repair Of Dural/Cerebrospinal Fluid Leak Or Pseudomeningocele With La |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63704. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63704 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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