CPT 63702
Global 090 ActiveRepair of spinal herniation
CPT 63702 Billing & Documentation Guide
CPT code 63702 (Repair of spinal herniation) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 18.92, a non-facility practice expense RVU of 16.06, and a malpractice RVU of 7.98, a total non-facility RVU of 42.96 and facility RVU of 42.96. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1432.82, though rates vary from $1227.81 to $1864.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 63702, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 63702 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 63702 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 63702
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 18.92 | 18.92 |
| Practice Expense RVU | 16.06 | 16.06 |
| Malpractice RVU | 7.98 | 7.98 |
| Total RVU | 42.96 | 42.96 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 63702
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1433.87 | $1433.87 | $1373.47 - $1617.84 | 29 |
| Florida | $1689.01 | $1689.01 | $1545.37 - $1864.43 | 3 |
| Georgia | $1463.55 | $1463.55 | $1428.14 - $1498.96 | 2 |
| Illinois | $1661.83 | $1661.83 | $1538.3 - $1787.18 | 4 |
| Michigan | $1510.8 | $1510.8 | $1422.62 - $1598.97 | 2 |
| North Carolina | $1302.74 | $1302.74 | $1302.74 - $1302.74 | 1 |
| New York | $1622.71 | $1622.71 | $1328.92 - $1805.15 | 5 |
| Ohio | $1390.37 | $1390.37 | $1390.37 - $1390.37 | 1 |
| Pennsylvania | $1447.99 | $1447.99 | $1376.26 - $1519.71 | 2 |
| Texas | $1411.11 | $1411.11 | $1367.7 - $1536.42 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 63702
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 63702 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0230T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0565T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 63702
What does CPT code 63702 mean? +
CPT code 63702 represents: Repair of spinal herniation. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 63702? +
The 2026 Medicare national average non-facility payment for CPT 63702 is $1432.82. Rates range from $1227.81 to $1864.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 63702? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 63702? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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