CPT code 61140: Brain biopsy, burr-hole or trephine approach2026 Medicare rate & RVUs
Reports neurosurgical tissue sampling of brain or an intracranial lesion through a burr hole or trephine for diagnostic evaluation.
Medicare pays $1,267.90 for 61140 nationally in a facility.
Medicare rate · 61140
Brain biopsy, burr-hole or trephine approach
- Work RVUs
- 16.8
- Total RVUs
- 37.96
- Global days
- 090
National rate · 2026
$1,267.90
Facility setting, before claim adjustments.
See every locality for 61140 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 61140 covers
A neurosurgeon makes a small cranial opening with a burr hole or trephine and removes tissue from the brain or an intracranial lesion for diagnosis. The procedure is generally performed in an operating room, often to obtain tissue from a radiographically identified mass or abnormal brain tissue when a pathologic diagnosis is needed. The specimen is submitted for examination.
Report 61140 when the documented operation is a biopsy through this access, rather than ventricular puncture or therapeutic drainage. The operative note should identify the target, approach, and tissue obtained; the use of a burr hole alone does not establish this code. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon and team-surgery billing are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 61140 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $1,107.10 |
| Alaska | Unavailable | $1,473.89 |
| Arizona | Unavailable | $1,219.49 |
| Arkansas | Unavailable | $1,087.59 |
| Atlanta, GA | Unavailable | $1,324.27 |
| Austin, TX | Unavailable | $1,269.68 |
| Bakersfield, CA | Unavailable | $1,232.22 |
| Baltimore area, MD | Unavailable | $1,366.92 |
| Beaumont, TX | Unavailable | $1,208.74 |
| Brazoria, TX | Unavailable | $1,216.55 |
| Chicago, IL | Unavailable | $1,577.83 |
| Chico, CA | Unavailable | $1,213.98 |
| Colorado | Unavailable | $1,253.51 |
| Connecticut | Unavailable | $1,364.73 |
| Dallas, TX | Unavailable | $1,237.76 |
| Delaware | Unavailable | $1,241.35 |
| Detroit, MI | Unavailable | $1,412.22 |
| East St. Louis, IL | Unavailable | $1,467.87 |
| El Centro, CA | Unavailable | $1,215.15 |
| Fort Lauderdale, FL | Unavailable | $1,463.49 |
| Fort Worth, TX | Unavailable | $1,236.09 |
| Fresno, CA | Unavailable | $1,213.98 |
| Galveston, TX | Unavailable | $1,228.75 |
| Hanford, CA | Unavailable | $1,213.98 |
| Hawaii, Guam, HI | Unavailable | $1,233.89 |
| Houston, TX | Unavailable | $1,357.24 |
| Idaho | Unavailable | $1,106.55 |
| Indiana | Unavailable | $1,112.90 |
| Iowa | Unavailable | $1,086.37 |
| Kansas | Unavailable | $1,106.26 |
| Kentucky | Unavailable | $1,195.54 |
| King County, WA | Unavailable | $1,360.26 |
| Los Angeles, CA | Unavailable | $1,298.55 |
| Madera, CA | Unavailable | $1,213.98 |
| Manhattan, NY | Unavailable | $1,517.72 |
| Marin County, CA | Unavailable | $1,387.99 |
| Merced, CA | Unavailable | $1,213.98 |
| Metropolitan Boston, MA | Unavailable | $1,356.74 |
| Metropolitan Kansas City, MO | Unavailable | $1,233.70 |
| Metropolitan Philadelphia, PA | Unavailable | $1,342.62 |
| Metropolitan St. Louis, MO | Unavailable | $1,245.70 |
| Miami, FL | Unavailable | $1,645.77 |
| Minnesota | Unavailable | $1,116.52 |
| Mississippi | Unavailable | $1,141.05 |
| Modesto, CA | Unavailable | $1,213.98 |
| Montana | Unavailable | $1,267.43 |
| Napa, CA | Unavailable | $1,338.08 |
| Nebraska | Unavailable | $1,085.69 |
| Nevada | Unavailable | $1,229.21 |
| New Hampshire | Unavailable | $1,257.95 |
| New Mexico | Unavailable | $1,275.83 |
| New Orleans, LA | Unavailable | $1,271.92 |
| North Carolina | Unavailable | $1,151.61 |
| North Dakota | Unavailable | $1,128.62 |
| Northern New Jersey | Unavailable | $1,394.76 |
| NYC suburbs and Long Island, NY | Unavailable | $1,594.02 |
| Ohio | Unavailable | $1,228.68 |
| Oklahoma | Unavailable | $1,165.08 |
| Oxnard, CA | Unavailable | $1,281.17 |
| Portland, OR | Unavailable | $1,269.27 |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | $1,387.26 |
| Puerto Rico | Unavailable | $1,269.58 |
| Queens, NY | Unavailable | $1,493.41 |
| Redding, CA | Unavailable | $1,213.98 |
| Rest of California | Unavailable | $1,213.98 |
| Rest of Florida | Unavailable | $1,365.06 |
| Rest of Georgia | Unavailable | $1,261.91 |
| Rest of Illinois | Unavailable | $1,358.82 |
| Rest of Louisiana | Unavailable | $1,203.74 |
| Rest of Maine | Unavailable | $1,141.48 |
| Rest of Maryland | Unavailable | $1,259.95 |
| Rest of Massachusetts | Unavailable | $1,254.31 |
| Rest of Michigan | Unavailable | $1,257.06 |
| Rest of Missouri | Unavailable | $1,196.63 |
| Rest of New Jersey | Unavailable | $1,356.54 |
| Rest of New York | Unavailable | $1,174.64 |
| Rest of Oregon | Unavailable | $1,196.37 |
| Rest of Pennsylvania | Unavailable | $1,216.27 |
| Rest of Texas | Unavailable | $1,221.07 |
| Rest of Washington | Unavailable | $1,244.18 |
| Rhode Island | Unavailable | $1,268.82 |
| Riverside, CA | Unavailable | $1,288.87 |
| Sacramento, CA | Unavailable | $1,256.29 |
| Salinas, CA | Unavailable | $1,251.59 |
| San Benito County, CA | Unavailable | $1,429.58 |
| San Diego, CA | Unavailable | $1,269.91 |
| San Francisco, CA | Unavailable | $1,380.02 |
| San Luis Obispo, CA | Unavailable | $1,234.29 |
| Santa Clara County, CA | Unavailable | $1,396.99 |
| Santa Cruz, CA | Unavailable | $1,272.43 |
| Santa Maria, CA | Unavailable | $1,253.21 |
| Santa Rosa, CA | Unavailable | $1,283.62 |
| South Carolina | Unavailable | $1,196.83 |
| South Dakota | Unavailable | $1,112.21 |
| Southern Maine, ME | Unavailable | $1,177.13 |
| Stockton, CA | Unavailable | $1,213.98 |
| Suburban Chicago, IL | Unavailable | $1,465.59 |
| Tennessee | Unavailable | $1,116.36 |
| Utah | Unavailable | $1,215.64 |
| Vallejo, CA | Unavailable | $1,326.59 |
| Vermont | Unavailable | $1,147.34 |
| Virgin Islands, VI | Unavailable | $1,269.58 |
| Virginia | Unavailable | $1,190.93 |
| Visalia, CA | Unavailable | $1,213.98 |
| Washington, DC area | Unavailable | $1,408.76 |
| West Virginia | Unavailable | $1,307.09 |
| Wisconsin | Unavailable | $1,085.81 |
| Wyoming | Unavailable | $1,206.93 |
| Yuba City, CA | Unavailable | $1,213.98 |
61140 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 61140 rate is calculated
Each of 61140’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 61140
RVUs × geographic indexes × conversion factor
Work16.80
16.80 RVUs× 1.000 GPCI
Practice expense14.14
14.14 RVUs× 1.000 GPCI
Malpractice7.02
7.02 RVUs× 1.000 GPCI
Adjusted RVUs
37.9600
Conversion factor
$33.4009
Medicare rate
$1,267.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61140
61140 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61140
Brain biopsy, burr-hole or trephine approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 61140
Brain biopsy, burr-hole or trephine approach
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
61140 without 51 · national facility
$1,267.90
Brain biopsy, burr-hole or trephine approach
61140-51 · Second procedure: 50%
$633.95
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
61140 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61120Ventricular punctureBurr-hole access
- Use 61140 for tissue sampling from brain or an intracranial lesion. Code 61120 describes ventricular puncture through a burr hole.
- 61150Intracranial drainageAbscess or cyst
- 61140 is diagnostic tissue sampling. Code 61150 describes drainage of a brain abscess or cyst.
- 61750Brain biopsyWithout CT/MR guidance
- 61140 describes biopsy through a burr hole or trephine; 61750 is for stereotactic biopsy, aspiration, or excision of an intracranial lesion.
- 61154Hematoma drainageExtradural or subdural
- Use 61154 for burr-hole evacuation or drainage of a hematoma, not for biopsy of brain tissue or an intracranial lesion.
61140 billing questions
How is 61140 different from a stereotactic brain biopsy?
61140 describes biopsy through a burr hole or trephine. For a stereotactic biopsy of an intracranial lesion, consider 61750 when that technique is documented.
Can 61140 be reported for a ventricular puncture?
No. 61140 represents tissue sampling from brain or an intracranial lesion; 61120 describes a burr-hole procedure for ventricular puncture.
Does 61140 include drainage of a lesion?
The code represents biopsy, not therapeutic drainage. Use the code matching the operation performed when the surgeon drains an abscess, cyst, or hematoma instead of obtaining tissue for diagnosis.
Should modifier 50 be appended for biopsies on both sides?
No. Modifier 50 is inappropriate for this code.
What global and multiple-procedure rules affect 61140?
It has a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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