CPT 62141 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

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

CPT code 62141 codes for surgical removal of a portion of the skull and repair of a skull defect greater than 5 cm in diameter. This code captures a high-complexity cranial reconstructive procedure that is clinically significant due to its implications for intracranial protection, cosmesis and potential neurologic outcomes. Nationally, accurate coding of this procedure affects hospital surgical case mix, reimbursement for complex neurosurgical services, and quality reporting for cranial reconstruction.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and typical sites of service, benchmark considerations for utilization and payment, and the coding context needed for billing and administrative review. The publication highlights common billing modifiers and data limitations where input fields are not provided.

This summary equips billing managers, neurosurgery departments, and policy analysts with a concise reference to the code’s clinical meaning, where it is commonly performed, and the payer landscape relevant to national-level reporting and reimbursement discussions. Data not available in the input is noted where applicable in subsequent sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare62141CPTNeurosurgeryCranial ReconstructionCraniotomySurgical BillingHospital ServicesSkull Defect Repair

Billing Code Overview

CPT code 62141 describes a neurosurgical procedure in which the surgeon removes a portion of the skull (craniectomy/craniotomy) and repairs a skull defect that is larger than 5 cm in diameter. The procedure involves excision of a skull segment and reconstruction of the resulting defect to restore cranial integrity.

Service type: Surgical cranial bone removal and skull defect repair
Typical site of service: Hospital operating room (inpatient or outpatient surgical center depending on clinical context)

Clinical & Coding Specifications

Clinical Context

A 54-year-old male with a history of prior cranial trauma and a large calvarial defect measuring 6.5 cm in greatest diameter presents with symptomatic brain protection concerns and cosmetic deformity. Imaging (CT skull) confirms a full-thickness skull defect without active intracranial infection. The neurosurgical team schedules a cranioplasty with removal of bone flap remnants and repair of the defect using autologous bone graft or custom alloplastic implant. Preoperative workflow includes neurosurgical consultation, informed consent, pre-op labs and imaging, anesthesia evaluation, and perioperative antibiotics. On the day of service, the patient undergoes operative exposure of the defect, debridement, sizing and placement of the implant, fixation of the reconstruction to the surrounding calvarium, hemostasis, and layered wound closure. Postoperative care includes neurologic monitoring in the PACU or inpatient unit, wound checks, pain control, and discharge planning with outpatient follow-up for incision assessment and imaging as indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the work, time, or complexity substantially exceeds usual for the procedure (document specific reasons and increased work).
`23`

CPT 62145: Cranial Reconstruction with Brain Tissue Repair

CPT-62115-CRANIAL-SKULL-REDUCTION-CRANIOMEGALY

CPT 62115: Reduction of Enlarged Skull (Craniomegaly)

CPT-62146-AUTOLOGOUS-CRANIOPLASTY-SKULL-DEFECT-≤5CM

CPT 62146: Autologous Cranioplasty for Skull Defect ≤5 cm

CPT-62142-CRANIAL-IMPLANT-BONE-FLAP-REMOVAL

CPT 62142: Removal of Bone Flap or Prosthetic Skull Plate

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

CPT 62120: Cranial Vault Repair and Skull Defect Reconstruction

CPT-62005-ELEVATION-DEPRESSED-SKULL-FRACTURE

CPT 62005: Elevation of Depressed Skull Fracture

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

CPT 62148: Cranioplasty Using Previously Stored Autologous Cranial Bone Graft

CPT-62117-CRANIAL-RECONSTRUCTION-SKULL-RECONTOURING

CPT 62117: Cranial Reconstruction for Craniomegaly

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

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

CPT 62010: Elevation of Depressed Skull Fracture with Dura Repair

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Taxonomy Code	Specialty	Notes
207P00000X	Neurological Surgery	Primary specialty performing cranioplasty and skull defect repair.
208000000X	General Surgery	May assist or perform in collaboration for complex reconstructions or multi-disciplinary cases.
261QP2000X	Plastic and Reconstructive Surgery	Commonly participates for soft-tissue and cosmetic reconstruction of calvarial defects.
207L00000X	Oral and Maxillofacial Surgery	Occasionally involved when defects extend to facial skeleton or require specialized fixation.
2084P0800X	Surgical Oncology	May be involved if the defect is related to tumor resection requiring oncologic reconstruction.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S02.89`	Other fractures of skull and facial bones	Skull fractures leading to bone loss or malunion that require reconstruction.
`S06.2X0`	Diffuse traumatic brain injury without loss of consciousness	Traumatic brain injury often associated with craniectomy and subsequent cranioplasty to repair defect.
`T90.2`	Sequelae of fracture of skull and facial bones	Late effects of prior skull fracture necessitating corrective skull reconstruction.
`D69.5`	Secondary thrombocytopenia	Hemostatic disorders that affect perioperative bleeding risk and surgical planning.
`G93.6`	Cerebral edema	May be present in patients who previously underwent decompressive craniectomy and now require protective cranioplasty.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61512`	Craniectomy or craniotomy, suboccipital or posterior fossa; for posterior fossa lesions	Performed when access to posterior fossa lesions precedes or accompanies skull reconstruction, or for decompression prior to cranioplasty.
`62140`	Craniectomy or craniotomy for cranial defect repair, skull defect 5 cm or less	Represents a similar skull defect repair for defects 5 cm or less; used for sizing-based code selection relative to `62141`.
`22845`	Insertion of interbody biomechanical device, anterior approach, for spine — (example adjacent procedure)	May be performed in multi-region reconstructions or when stabilization devices are needed; included when spine procedures occur in same operative setting.
`69990`	Microneurosurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)	Reported when operating microscope is required during delicate skull reconstruction or intracranial work.
`20680`	Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail)	Used when prior hardware is removed during preparation for cranioplasty.
`99199`	Unlisted special service, procedure or report	May be used for novel or custom alloplastic implant fabrication/processing charges when no specific code exists (use per payer guidance).

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