What Does CPT Code 00215 Mean?

CPT code 00215 describes anesthesia services provided for cranioplasty or elevation of a depressed skull fracture. This code covers the surgical repair or reconstruction of the cranial vault, including the elevation of bone fragments that have been depressed below the level of the surrounding skull.

Cranioplasty is the surgical repair of a cranial defect, typically performed after a prior craniectomy or craniotomy. The bone flap may be replaced, or a synthetic material (titanium mesh, polymethyl methacrylate, or custom 3D-printed implant) may be used. Elevation of a depressed skull fracture is an urgent or emergent procedure to lift depressed bone fragments that may be impinging on the underlying brain tissue. Both procedures are extradural, meaning the dura is not intentionally opened, though dural tears may occur.

Key Code Attributes:

• Billable Status: Fully billable as a standalone anesthesia service
• Base Units (CMS 2026): 9
• Primary Setting: Hospital operating room, trauma center, or neurosurgical suite
• Provider Type: Anesthesiologist (MD/DO) or CRNA with physician supervision
• Service Category: General anesthesia
• Effective Status: Active CPT code with no planned retirement (verified through 2026)
• Typical Patient Population: Trauma patients with depressed skull fracture; patients with prior cranial defect requiring reconstruction (elective cranioplasty)

What Services and Procedures Does CPT Code 00215 Cover?

CPT 00215 covers anesthesia for extradural cranial procedures including cranioplasty and elevation of depressed skull fracture.

Covered Procedures and Surgical Indications:

• Cranioplasty for repair of cranial defect after prior craniectomy
• Elevation of simple depressed skull fracture
• Elevation of compound depressed skull fracture
• Cranioplasty using autologous bone graft
• Cranioplasty using synthetic implant (titanium, PEEK, PMMA)
• Cranioplasty using custom 3D-printed implant
• Repair of cranial bone flap after craniotomy

What Does CPT Code 00215 Specifically Exclude?

CPT 00215 does not cover anesthesia for:

• Craniotomy with dural opening for tumor resection or aneurysm clipping (use 00210-00220)
• Burr hole procedures (use 00210, 00211, 00214)
• Subdural tap (use 00212)
• Procedures involving the spine or spinal cord (use 00600-00670)

When Is CPT Code 00215 the Right Code to Use?

Use CPT 00215 when the surgical procedure involves either (1) cranioplasty to repair a cranial defect or (2) elevation of a depressed skull fracture, and the procedure is extradural.

Step-by-Step Code Selection:

1. Confirm the procedure is extradural (dura is not intentionally opened)
2. Verify the procedure involves bone work on the cranial vault
3. If the procedure is a craniotomy with dural opening (tumor, aneurysm, etc.), use 00210-00220 instead
4. If the procedure is a burr hole only, use 00210-00214

How Does CPT Code 00215 Differ From Other Cranial Anesthesia Codes?

| Code | Procedure | Base Units | |---

---|-----------|------------| | 00210 | Craniotomy or craniectomy (simple) | 11 | | 00212 | Subdural tap | 5 | | 00214 | Burr holes with ventriculography | 9 | | 00215 | Cranioplasty or elevation of depressed skull fracture | 9 | | 00216 | Craniotomy for vascular lesion (aneurysm, AVM) | 15 |

What Documentation Is Required to Support CPT 00215?

Required Documentation Elements:

• ASA Physical Status Classification
• Start and stop times
• Type and dosage of anesthetic agents
• Airway management technique
• Positioning (supine, Mayfield pins if used)
• Estimated blood loss
• Fluid and blood product administration
• Antibiotic administration timing
• Postoperative neurologic assessment

Key Takeaways for Billing and Coding CPT 00215

• CPT 00215 covers cranioplasty and elevation of depressed skull fracture
• Base units are 9 under the 2026 CMS Physician Fee Schedule
• The procedure must be extradural (no intentional dural opening)
• Emergency elevation of depressed fracture may qualify for physical status modifier 5P or 6P (higher units)

Additional Resources and References

• CMS Physician Fee Schedule: Official source for base units and conversion factors
• ASA Relative Value Guide: The American Society of Anesthesiologists annual RVG
• AMA CPT Professional Edition: The official CPT code set