CPT 62100 Cranial Dural Repair Reimbursement | OpenPayer

Summary & Overview

CPT 62100: Cranial Dural Repair for Cerebrospinal Fluid Leak

CPT code 62100 represents an open cranial dural repair to correct cerebrospinal fluid (CSF) leakage caused by a dural tear. This neurosurgical procedure is clinically important because untreated CSF leaks can lead to meningitis, persistent CSF drainage through the nose or ear, and other neurologic complications. Nationally, the code is relevant for hospital surgical services and specialty neurosurgical billing, affecting reimbursement, utilization monitoring, and quality reporting for cranial procedures.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service represented by the code, typical sites of service, and common billing contexts. The publication outlines benchmarking considerations, payment and coverage trends where available, and clinical context relevant to coding and hospital service lines. It also summarizes typical modifiers and operational factors used with the code. Data not available in the input will be noted where applicable.

This summary is intended for billing managers, clinical coders, neurosurgeons, and policy analysts seeking a clear national-level briefing on CPT code 62100, its clinical purpose, and the payer landscape for cranial dural repair procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 62100neurosurgerycranial surgerydural repairCSF leakhospital surgeryoperative proceduresurgical coding

Billing Code Overview

CPT code 62100 describes a surgical procedure in which the surgeon performs a cranial incision and opens the cranium to repair a cerebrospinal fluid (CSF) leak resulting from a dural tear. The dural repair addresses CSF drainage through the nose (rhinorrhea) or the ear (otorrhea) and restores the integrity of the dura, the outer membrane covering the brain.

Service type: Open cranial dural repair for CSF leak
Typical site of service: Inpatient or outpatient hospital operating room, depending on case complexity and need for monitoring

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient presents with persistent clear rhinorrhea following a basilar skull fracture sustained in a motor vehicle collision. Neurologic exam is stable but the patient reports salty-tasting nasal drainage and positional headache. Imaging with CT and MRI cisternography localizes a dural defect at the anterior cranial fossa with active cerebrospinal fluid (CSF) leak. After discussion in multidisciplinary skull base conference, the neurosurgery team schedules a craniotomy for direct dural repair and reconstruction of the skull base defect. Preoperative workflow includes informed consent, cross-sectional imaging review, anesthesia evaluation, antibiotic prophylaxis, and availability of graft materials (autologous pericranium or synthetic dural graft). Intraoperatively, the neurosurgeon performs a skull incision, elevates a bone flap to open the cranium, identifies the dural breach, and repairs the dura with primary suture and/or graft with watertight closure. If needed, adjunctive measures (fat graft, vascularized flap, lumbar drain) are used to reduce pressure on the repair. Postoperative care includes ICU or monitored bed observation for neurologic status, head elevation, CSF leak surveillance, and instructions to avoid Valsalva. The procedure resolves CSF drainage through the nose or ear and reduces risk of meningitis and other complications.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the dural repair requires substantially greater effort, complexity, or time than usual due to extensive dural loss or complex reconstruction.

CPT 62115: Reduction of Enlarged Skull (Craniomegaly)

CPT-62143-CRANIAL-BONE-FLAP-OR-PROSTHETIC-SKULL-PLATE-REPLACEMENT

CPT 62143: Replacement of Bone Flap or Prosthetic Skull Plate

CPT-62121-SKULL-BASE-ENCEPHALOCELE-REPAIR-CRANIOTOMY

CPT 62121: Repair of Skull Base Encephalocele, Craniotomy

CPT-62010-DEPRESSED-SKULL-FRACTURE-ELEVATION-DURA-REPAIR

CPT 62010: Elevation of Depressed Skull Fracture with Dura Repair

CPT-62005-ELEVATION-DEPRESSED-SKULL-FRACTURE

CPT 62005: Elevation of Depressed Skull Fracture

CPT-62117-CRANIAL-RECONSTRUCTION-SKULL-RECONTOURING

CPT 62117: Cranial Reconstruction for Craniomegaly

CPT-62145-CRANIAL-RECONSTRUCTION-WITH-BRAIN-REPAIR

CPT 62145: Cranial Reconstruction with Brain Tissue Repair

CPT-62000-DEPRESSED-SKULL-FRACTURE-ELEVATION-BURR-HOLE

CPT 62000: Elevation of Closed Depressed Skull Fracture via Burr Hole

CPT-62120-CRANIAL-VAULT-REPAIR-SKULL-DEFECT-RECONSTRUCTION

CPT 62120: Cranial Vault Repair and Skull Defect Reconstruction

CPT-62140-CRANIAL-BONE-REMOVAL-AND-SKULL-DEFECT-REPAIR-UP-TO-5CM

CPT 62140: Cranial Bone Removal and Skull Defect Repair, Up to 5 cm

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Taxonomy Code	Specialty	Notes
207P00000X	Neurological Surgery	Primary specialty performing craniotomy and dural repair.
207L00000X	Otolaryngology (ENT)	Frequently participates for skull base exposure and endoscopic/endoscopic-assisted approaches.
2080P0003X	Neurology — Surgery subspecialist	Neurosurgical subspecialist involvement for complex skull base pathology.
2084P0800X	Plastic and Reconstructive Surgery	May participate for soft tissue and scalp reconstruction when extensive flaps or grafts are required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S02.0X0A`	Fracture of vault of skull, initial encounter for closed fracture	Skull fractures can cause dural tears leading to CSF leak requiring dural repair.
`S02.1XXA`	Fracture of base of skull, initial encounter for closed fracture	Basilar skull fractures commonly produce CSF otorrhea or rhinorrhea necessitating repair.
`G96.0`	Cerebrospinal fluid leak	Direct diagnosis indicating active CSF leak addressed by dural repair.
`G97.4`	Postprocedural cerebrospinal fluid leak	CSF leak occurring after prior cranial procedure that may require reoperation and dural repair.
`A87.9`	Viral meningitis, unspecified	While not a direct indication for repair, history of meningitis or risk from CSF leak influences urgency of repair.
`T90.9`	Sequelae of injury of head, unspecified	Chronic sequelae from head injury may include persistent CSF leak or dural defects that require repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61304`	Craniotomy or craniectomy, with excision or evacuation of lesion, supratentorial; for trauma	Performed when initial management requires evacuation of hematoma or decompression prior to or at the time of dural repair.
`61620`	Repair of dural defect, cranium (separate procedure)	Codes for supplemental dural reconstruction techniques may be reported when distinct from primary dural repair; selected in complex reconstructions.
`62280`	Spinal dural repair (for comparison)	Not directly cranial but represents dural repair procedures in the spine; useful for coding parallels in dural repair technique.
`61645`	Repair of cerebrospinal fluid leak, anterior cranial base, open approach	Often used for skull base CSF leak repairs via open approaches and closely related to `62100` when leak originates at the anterior cranial fossa.
`61020`	Repair of dura mater (cranial)	Adjunct code representing dural repair elements sometimes reported; verify payer rules for bundling with `62100`.

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