CPT code 61151: Subdural tap, burr hole or trephine2026 Medicare rate & RVUs in California
Reports a neurosurgical burr-hole or trephine approach to tap a subdural collection, rather than evacuating or draining a hematoma.
CMS doesn’t publish an office rate for 61151 in California.
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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What 61151 covers
A neurosurgeon creates a burr hole or uses a trephine to access the subdural space and perform a tap, typically to obtain or remove subdural fluid. The code distinguishes this limited tapping procedure from an operation that evacuates or establishes drainage for a subdural hematoma. It is generally performed in an operating-room setting.
Report 61151 when the operative record supports a subdural tap through a burr hole or trephine; document the target space, approach, and action performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery 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 61151 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $970.26 |
| Chico, CA | Unavailable | $955.87 |
| El Centro, CA | Unavailable | $956.80 |
| Fresno, CA | Unavailable | $955.87 |
| Hanford, CA | Unavailable | $955.87 |
| Los Angeles, CA | Unavailable | $1,022.65 |
| Madera, CA | Unavailable | $955.87 |
| Marin County, CA | Unavailable | $1,093.35 |
| Merced, CA | Unavailable | $955.87 |
| Modesto, CA | Unavailable | $955.87 |
| Napa, CA | Unavailable | $1,053.94 |
| Oxnard, CA | Unavailable | $1,008.98 |
| Redding, CA | Unavailable | $955.87 |
| Rest of California | Unavailable | $955.87 |
| Riverside, CA | Unavailable | $1,014.97 |
| Sacramento, CA | Unavailable | $989.28 |
| Salinas, CA | Unavailable | $985.59 |
| San Benito County, CA | Unavailable | $1,126.16 |
| San Diego, CA | Unavailable | $1,000.10 |
| San Francisco, CA | Unavailable | $1,087.06 |
| San Luis Obispo, CA | Unavailable | $971.96 |
| Santa Clara County, CA | Unavailable | $1,100.44 |
| Santa Cruz, CA | Unavailable | $1,002.15 |
| Santa Maria, CA | Unavailable | $986.89 |
| Santa Rosa, CA | Unavailable | $1,010.96 |
| Stockton, CA | Unavailable | $955.87 |
| Vallejo, CA | Unavailable | $1,044.88 |
| Visalia, CA | Unavailable | $955.87 |
| Yuba City, CA | Unavailable | $955.87 |
How the 61151 rate is calculated
Each of 61151’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 · 61151
RVUs × geographic indexes × conversion factor
Work13.15
13.15 RVUs× 1.000 GPCI
Practice expense11.20
11.20 RVUs× 1.000 GPCI
Malpractice5.54
5.54 RVUs× 1.000 GPCI
Adjusted RVUs
29.8900
Conversion factor
$33.4009
Medicare rate
$998.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61151
61151 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61151
Subdural tap, burr hole or trephine
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 61151
Subdural tap, burr hole or trephine
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
61151 without 51 · national facility
$998.35
Subdural tap, burr hole or trephine
61151-51 · Second procedure: 50%
$499.18
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%).
61151 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61105Twist-drill punctureHematoma drainage
- 61105 uses a twist-drill hole for subdural or ventricular puncture. 61151 is selected for a subdural tap through a burr hole or trephine.
- 61108Subdural drainageTwist-drill approach
- 61108 describes twist-drill evacuation and/or drainage of a subdural hematoma. 61151 describes a tap through a burr hole or trephine.
- 61154Hematoma drainageExtradural or subdural
- Use 61154 when the surgeon evacuates and/or drains a subdural hematoma through a burr hole or trephine; 61151 is for tapping the subdural space.
- 61156Burr-hole aspirationIntracerebral hematoma or cyst
- 61156 involves aspiration of an intracerebral hematoma or cyst. 61151 targets the subdural space.
61151 billing questions
How is 61151 different from 61154?
61151 represents a subdural tap. Choose 61154 when the surgeon evacuates and/or drains a subdural hematoma.
When would 61105 be considered instead?
61105 describes a twist-drill approach for subdural or ventricular puncture. 61151 is for a tap performed through a burr hole or trephine.
Can the burr-hole access be billed separately?
The burr hole or trephine is part of the service described by 61151; do not report a separate access procedure for the same approach.
Should modifier 50 be used for bilateral taps?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports 61151?
The operative report should identify the subdural target, burr-hole or trephine approach, and that a tap was performed rather than hematoma evacuation or drainage.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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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