CPT 62145 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 62145: Cranial Reconstruction with Brain Tissue Repair

CPT code 62145 denotes a surgical cranial reconstruction performed with concurrent repair of brain tissue. The code captures combined skull defect correction and intracranial repair completed in the same operative session, a procedure relevant to neurosurgery and craniofacial teams. Nationally, accurate coding for these complex procedures affects hospital billing, case-mix assignment, and quality measurement for high-acuity neurosurgical care. Key payers in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, typical payer coverage considerations, common modifier use, and guidance on interpreting related coding elements. The publication highlights benchmarks and payment policy updates relevant to inpatient and outpatient surgical settings, outlines clinical scenarios that commonly map to the code, and lists related resources for diagnosis and billing cross-reference. Data not available in the input is identified where applicable.

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Billing Code Overview

CPT code 62145 describes a surgical procedure in which the provider corrects a skull defect and, during the same operative session, performs repair of brain tissue. This represents a combined cranial reconstruction and intracranial repair procedure.

Service type: Surgical cranial reconstruction with concurrent brain tissue repair
Typical site of service: Hospital inpatient or outpatient operating room, depending on clinical complexity and patient condition

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who presents with a depressed or traumatically created skull defect with associated underlying cortical injury or herniation requiring simultaneous cranioplasty and brain repair. The patient often has a history of recent severe head trauma, compound skull fracture, or prior decompressive craniectomy complicated by dural or cortical injury. Preoperative imaging (CT and MRI) demonstrates a skull bone defect with contusion, cortical laceration, entrapped brain tissue, or cerebrospinal fluid leak. The clinical workflow includes emergency department evaluation or neurosurgical referral, stabilization of airway/breathing/circulation, neurosurgical operative planning, informed consent, general endotracheal anesthesia, and preparation for craniotomy/craniectomy. In the operating room the surgeon debrides and repairs injured brain tissue (hemostasis, dural repair, cortical reconstruction as needed) and reconstructs the skull defect using autologous bone flap replacement or prosthetic cranioplasty material. Postoperatively the patient is monitored in a neurocritical care unit with serial neurologic exams and imaging to evaluate graft position, brain re-expansion, and to detect complications such as infection, hemorrhage, or CSF leak. Typical sites of service are the operating room within an acute care hospital or an ambulatory surgical center when clinically appropriate. Common ICD-10 diagnoses prompting this procedure include traumatic skull fracture with intracranial injury, open skull wound with brain injury, or complications of prior cranial surgery requiring repair.

Coding Specifications

Modifier	Description	When to Use
`00`

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

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

CPT 62148: Cranioplasty Using Previously Stored Autologous Cranial Bone Graft

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

CPT 62120: Cranial Vault Repair and Skull Defect Reconstruction

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

CPT 62010: Elevation of Depressed Skull Fracture with Dura Repair

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

CPT 62146: Autologous Cranioplasty for Skull Defect ≤5 cm

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

CPT 62143: Replacement of Bone Flap or Prosthetic Skull Plate

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

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

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

CPT 62121: Repair of Skull Base Encephalocele, Craniotomy

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Taxonomy Code	Specialty	Notes
`207L00000X`	Neurological Surgery	Primary specialty performing cranial defect repair with brain repair.
`207RH0000X`	Surgery — Neurosurgery	Alternative taxonomy often used by hospitals and outpatient surgical centers.
`207W00000X`	Surgery — Neurocritical Care	Providers involved in perioperative neurocritical management.
`208000000X`	Surgery — General Surgery	Occasionally involved for combined head/face trauma reconstruction planning.
`363L00000X`	Physician Assistant	Common mid-level provider supporting neurosurgery in perioperative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S02.91XA`	Fracture of skull, unspecified, initial encounter	Common indication for surgical correction of skull defects with associated brain injury.
`S06.5X9A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Intracranial hemorrhage with skull fracture may necessitate repair of bone and injured brain tissue.
`S06.8X9A`	Other intracranial injuries, initial encounter	Includes cortical lacerations or contusions requiring operative repair alongside cranioplasty.
`S01.01XA`	Open bite of scalp, initial encounter	Penetrating scalp/skull injuries with brain involvement that require debridement and skull repair.
`T81.4XXA`	Infection following a procedure, initial encounter	Postoperative infections can necessitate revision skull repair and brain tissue management.
`Z98.89`	Other specified postprocedural states	Indicates prior cranial surgery such as decompressive craniectomy leading to later reconstructive repair.
`S06.3X0A`	Focal traumatic brain injury without loss of consciousness, initial encounter	Focal cortical injury that may be addressed during the same session as skull defect repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61312`	Craniectomy or craniotomy for excision of skull lesion(s) when performed with tumor excision — exposed bone and intracranial lesion management	Performed when lesion resection precedes or coincides with skull reconstruction; may be staged with `62145` for reconstruction and brain repair.
`61520`	Cranioplasty; for congenital skull defect or for repair of traumatic or acquired skull defects (includes molding, fixation)	Commonly performed in conjunction with skull defect repair; if listed separately, indicates extensive reconstructive work beyond `62145` scope.
`61105`	Repair of cranial fracture; open, with debridement and/or cranial bone fragment removal	Performed in acute traumatic settings where fragments are removed prior to reconstructive repair with brain tissue repair documented under `62145`.
`61782`	Stereotactic or open biopsy of brain lesion (if applicable)	Occasionally performed prior to or during skull repair when intracranial pathology requires sampling concurrent with repair.
`99291`	Critical care, evaluation and management of the critically ill or injured patient, first 30-74 minutes	Used for intensive perioperative neurocritical care management when documented separately from the surgical global period.
`99152`	Moderate sedation services provided by the same physician performing a procedure (examples)	Used if moderate sedation is reported separately and payer allows when anesthesia reporting requirements differ from general anesthesia codes.

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