Surgical · Spine

Placement of a graft to repair a defect in the spinal dura mater, the outermost membrane encasing the spinal cord.

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,045.78
Work RVU: 15.02
Global, days: 90
Region: Spine

Drawn from CMSNervesProvidencehealthplanAAPC

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Specify the nature and etiology of the dural defect (e.g., traumatic, post-resection, congenital, CSF leak with pseudomeningocele)
Identify graft material used — autologous tissue or synthetic product name (e.g., DuraGen, DuraSeal) and dimensions
Document that the repair was a formal graft procedure, not closure of a minor intraoperative dural nick
State whether an operating microscope was used and identify the system by name if billing 69990
Record spinal level(s) involved and the primary procedure performed at that level
Note fixation method — sutures, medical adhesive, or both — and confirm watertight closure attempt

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service 62 Co-surgeons 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 63710 covers spinal dural grafting — the application of an autologous or synthetic graft to close a dural defect. This is a distinct repair procedure, not a simple intraoperative suture closure. Indications include persistent CSF leaks, traumatic dural injuries, post-tumor resection defects, and congenital dural malformations requiring formal graft augmentation.

This code carries a 90-day global period and is billed as a standalone procedure or alongside the primary spinal surgery that necessitated the dural repair. CMS restricts use: do not report 63710 for routine small intraoperative dural lacerations or for procedures that are inherently intradural. Dural tears from fractures are an accepted indication. The code is performed exclusively in an inpatient hospital setting.

One key add-on opportunity: the operating microscope code 69990 is separately reportable with 63710 under Medicare and many commercial payers — it falls within the CMS-approved code range (63704–63710). Confirm this add-on is supported before billing; NCCI bundles 69990 into most surgical procedures outside that listed range, and edits typically do not allow modifier override.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (15.02) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (31.31) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	15.02
Practice expense RVU	11.63
Malpractice RVU	4.66
Total RVU	31.31
Medicare national rate	$1,045.78
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$1,045.78

Common denial reasons

The recurring reasons claims for CPT 63710 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billed for repair of a small intraoperative dural tear, which is not separately reportable per NCCI guidelines
Reported with inherently intradural procedures where dural entry is already included in the primary code
69990 add-on denied because operative note fails to name the microscope system or justify its distinct use
Missing documentation distinguishing formal graft repair from routine dural closure integral to the primary procedure
Site of service mismatch — 63710 is performed inpatient; claims submitted under outpatient facility settings trigger review

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can I bill 63710 every time there's an intraoperative dural tear?

No. NCCI policy explicitly prohibits reporting 63710 for small intraoperative dural lacerations or leaks. Reserve this code for formal graft placement to repair a distinct dural defect — such as one caused by trauma, tumor resection, or a significant CSF leak requiring augmentation beyond primary suture closure.

02Is 69990 separately payable with 63710 under Medicare?

Yes. CMS explicitly lists the range 63704–63710 as eligible for separate payment of the operating microscope add-on (69990). Document the microscope system by name in the operative report. NCCI bundles 69990 into most other surgical codes without modifier override, so confirm this is one of the approved pairings before billing.

03What's the difference between 63707, 63709, and 63710?

63707 is for dural or CSF leak repair not requiring laminectomy. 63709 covers dural or CSF leak repair or pseudomeningocele with laminectomy. 63710 is specifically for dural grafting — graft material is placed to augment or replace the dura. The distinction turns on whether a graft was used, not just sutured.

04What global period applies, and what does it cover?

63710 carries a 90-day global period. All routine post-op care related to the dural graft is bundled through day 90. Unrelated E/M visits in that window require modifier 24. A new, unrelated surgical procedure in the global requires modifier 79.

05Can 63710 be reported with the primary spinal procedure on the same date?

Yes, when the dural graft is performed as a separately documented procedure distinct from the primary surgery. Modifier 59 supports unbundling when NCCI edits fire. The operative note must make clear the graft repair was a distinct service with its own indication, not an integral part of the approach or closure.

06Is 63710 ever performed outpatient or in an ASC?

No. 63710 carries an inpatient-only designation under CMS. It is not eligible for ASC or outpatient hospital payment under Medicare. Claims submitted to outpatient facility fee schedules will be denied or converted.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the dural defect etiology, spinal level, graft material and product name, fixation method, and whether an operating microscope was used — including the system name. This prevents the most common denial trigger for 63710: operative notes that describe graft placement without distinguishing it from a routine intraoperative dural nick repair, and missing microscope documentation when 69990 is billed alongside.

See how Mira captures CPT 63710 documentation