CPT 62140 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

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

CPT code 62140 denotes a neurosurgical procedure for removal of a portion of the skull with repair of a skull defect up to 5 cm in diameter. Nationally, this code captures operative treatment of localized skull defects resulting from trauma, tumor resection, infection, or other cranial pathology and is consequential for surgical service-line billing, hospital resource planning, and neurosurgical quality measurement. Key payers typically involved in coverage and payment decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find clinical and billing context for CPT code 62140, including the procedure’s primary clinical indications, typical sites of service (operating room settings in inpatient and outpatient hospitals or ambulatory surgical centers), and how the code fits into surgical service-line workflows. The publication outlines common payer coverage considerations and the practical implications for hospital billing teams and neurosurgical practices. It also highlights areas where benchmarking and policy updates can affect utilization and documentation needs. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 62140neurosurgerycraniotomyskull repairoperative procedurehospital surgerysurgical codingcranial reconstructionbilling and compliance

Billing Code Overview

CPT code 62140 describes a neurosurgical procedure in which the surgeon removes a portion of the skull (craniectomy/craniotomy) and repairs a skull defect no larger than 5 cm in diameter. The procedure typically involves temporary or permanent removal of bone and reconstruction or repair of the cranial vault at the defect site.

Service type: Surgical, neurosurgical cranial bone removal and skull defect repair
Typical site of service: Inpatient hospital operating room or outpatient hospital/surgical center operating room depending on clinical indication and patient status.

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient presents with a symptomatic post-traumatic cranial defect measuring approximately 3.5 cm in greatest diameter after prior decompressive craniectomy. The patient reports localized scalp contour irregularity, intermittent headaches, and concern for brain protection and cosmesis. Preoperative evaluation includes neurologic exam, CT head to define defect size and contour, review of prior operative notes and implants, and medical optimization for anesthesia. The typical clinical workflow: preoperative imaging and consent; scheduling in an operating room with neurosurgical team and neuroanesthesia; induction of general anesthesia and positioning; surgical exposure of the cranial defect, debridement of bone edges, and measurement to confirm diameter ≤5 cm; repair using autologous bone, titanium mesh, or alloplastic cranioplasty material sized to defect; secure fixation and layered scalp closure; immediate postoperative neuro-observation in PACU or inpatient neurosurgical unit; postoperative imaging as indicated and routine wound checks. Typical site of service is an inpatient hospital operating room or ambulatory surgery center for select stable patients. Service type: open cranial repair (cranioplasty) for a skull defect no larger than 5 cm in diameter, performed by a neurosurgeon or craniofacial surgeon with assistance as indicated.

Coding Specifications

Modifier	Description	When to Use
`11`	Physician or other qualified health care professional service	Use to report the usual, unplanned service performed by the provider (default for primary procedure).

CPT 62142: Removal of Bone Flap or Prosthetic Skull Plate

CPT-62117-CRANIAL-RECONSTRUCTION-SKULL-RECONTOURING

CPT 62117: Cranial Reconstruction for Craniomegaly

CPT-62005-ELEVATION-DEPRESSED-SKULL-FRACTURE

CPT 62005: Elevation of Depressed Skull Fracture

CPT-62100-CRANIAL-DURAL-REPAIR-CSF-LEAK

CPT 62100: Cranial Dural Repair for Cerebrospinal Fluid Leak

CPT-62147-CRANIOPLASTY-AUTOLOGOUS-BONE-GRAFT-LARGE-CRANIAL-DEFECT

CPT 62147: Cranioplasty with Autologous Bone Graft for Large Cranial Defect

CPT-62148-CRANIOPLASTY-RETRIEVAL-AUTOLOGOUS-CRANIAL-BONE-GRAFT

CPT 62148: Cranioplasty Using Previously Stored Autologous Cranial Bone Graft

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

CPT 62010: Elevation of Depressed Skull Fracture with Dura Repair

CPT-62141-CRANIAL-BONE-REMOVAL-AND-SKULL-DEFECT-REPAIR-GREATER-THAN-5CM

CPT 62141: Cranial Bone Removal and Skull Defect Repair >5 cm

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

CPT 62120: Cranial Vault Repair and Skull Defect Reconstruction

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

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

Showing 1–10 of 15

Taxonomy Code	Specialty	Notes
2084P0800X	Neurological Surgery	Primary specialty performing cranioplasty and skull defect repair.
207H00000X	Otolaryngology (ENT)	Performs skull base and cranial reconstructive procedures when defects involve temporal bones or skull base exposure.
207X00000X	Plastic Surgery	Often involved for complex scalp reconstruction and aesthetic considerations in cranioplasty.
208000000X	General Surgery	Rarely performs limited cranial procedures in specific settings; included when multidisciplinary care occurs.
363L00000X	Oral and Maxillofacial Surgery	Involved when craniofacial skeletal reconstruction overlaps with facial bones or mandible.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S02.91XA`	Fracture of skull, unspecified, initial encounter	Acute or healed skull fracture leading to a cranial defect requiring repair.
`S06.6X0A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Prior decompression for traumatic intracranial hemorrhage can leave a craniectomy defect requiring cranioplasty.
`T81.31XA`	Disruption of wound, not elsewhere classified, initial encounter	Postoperative wound disruption or dehiscence necessitating repair of skull and scalp.
`D78.9`	Bone marrow disorder, unspecified	Represents metabolic or bone healing disorders that may impact cranioplasty timing or technique.
`Z98.890`	Other specified postprocedural states	Indicates prior cranial surgery (e.g., craniectomy) and a postprocedural state requiring reconstruction.
`G93.5`	Compression of brain (includes post-traumatic encephalopathy)	Clinical sequelae of prior injury prompting surgical reconstruction for protection and contour.
`M85.8`	Other specified disorders of bone density and structure	Conditions affecting bone quality that may influence graft choice or fixation method.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`21110`	Reconstruction, orbitomalar, zygomatic complex, craniofacial; with osteotomies and bone graft, open	May be performed in conjunction when craniofacial skeletal reconstruction is required near the skull defect.
`21248`	Reconstruction, mandible or maxilla, contiguous bone graft; microvascular free flap	Used when large composite defects require vascularized bone grafts that may be considered if skull defect reconstruction involves complex bone replacement beyond 5 cm.
`61312`	Craniotomy or craniectomy for tumor, supratentorial; with decompression and/or reconstruction	Performed for intracranial pathology that may necessitate subsequent cranioplasty such as `62140` for skull defect repair.
`62145`	Craniectomy or craniotomy with repair of cranial defect greater than 5 cm	Report when the skull defect exceeds 5 cm in diameter; alternative to `62140` for larger defects.
`22851`	Insertion of interbody biomechanical device (spine) — note: not cranial but listed when hardware-related billing occurs	Occasionally reported in systems where specialized implant billing codes are used; included for implant/ fixation context.
`69990`	Microscopic surgical techniques, requiring use of an operating microscope (list separately in addition to primary procedure)	Reported when an operating microscope is used during delicate skull defect repair or dural work.

OpenPayer