CPT code 61154: Hematoma drainage, extradural or subdural2026 Medicare rate & RVUs in California

Reports burr-hole evacuation or drainage of an extradural or subdural hematoma when the surgeon treats the collection through a cranial opening.

CMS RVU26DEffective Oct 1, 202629 payment localities4.7K Medicare services in 2024

CMS doesn’t publish an office rate for 61154 in California.

—Office (non-facility)
$1,235.46–$1,459.23Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 61154 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 61154 covers

A neurosurgeon creates one or more burr holes in the skull to reach and evacuate or drain an extradural (epidural) or subdural hematoma. The procedure may be used for acute or chronic blood collections when burr-hole access is the selected operative approach. It is typically performed in a hospital operating room, often for a patient with symptomatic intracranial bleeding or pressure from a hematoma.

Select this code for the hematoma’s extradural or subdural location and the burr-hole approach; a twist-drill procedure, intracerebral aspiration, or open craniotomy represents a different service. The operative report should identify the hematoma location, approach, and evacuation or drainage performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 applies to bilateral performance and is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is 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 61154 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

61154 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailable$1,253.62
Chico, CAUnavailable$1,235.46
El Centro, CAUnavailable$1,236.63
Fresno, CAUnavailable$1,235.46
Hanford, CAUnavailable$1,235.46
Los Angeles, CAUnavailable$1,321.96
Madera, CAUnavailable$1,235.46
Marin County, CAUnavailable$1,417.00
Merced, CAUnavailable$1,235.46
Modesto, CAUnavailable$1,235.46

How the 61154 rate is calculated

Each of 61154’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 · 61154

RVUs × geographic indexes × conversion factor

Office or facility?

Work16.64

16.64 RVUs× 1.000 GPCI

Practice expense14.89

14.89 RVUs× 1.000 GPCI

Malpractice6.99

6.99 RVUs× 1.000 GPCI

Adjusted RVUs

38.5200

Conversion factor

$33.4009

Medicare rate

$1,286.60

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 61154

61154 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61154

Hematoma drainage, extradural or subdural

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 61154

Hematoma drainage, extradural or subdural

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

61154 without 50 · national facility

$1,286.60

Hematoma drainage, extradural or subdural

61154-50 · Bilateral: 150%

$1,929.90

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

61154 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 61154

    Hematoma drainage, extradural or subdural16.64 wRVU

    Not priced

  • 61108

    Subdural drainage, twist-drill approach11.35 wRVU

    Not priced

  • 61156

    Burr-hole aspiration, intracerebral hematoma or cyst17.01 wRVU

    Not priced

  • 61312

    Hematoma evacuation, supratentorial, extra- or subdural29.42 wRVU

    Not priced

How to choose

61108Subdural drainageTwist-drill approach
Choose 61154 for burr-hole evacuation or drainage of an extradural or subdural hematoma. Code 61108 describes a twist-drill approach, including subdural drainage.
61156Burr-hole aspirationIntracerebral hematoma or cyst
Code 61156 is for aspiration of an intracerebral hematoma or cyst. Code 61154 is for an extradural or subdural hematoma treated through burr-hole access.
61312Hematoma evacuationSupratentorial, extra- or subdural
Code 61312 describes open craniotomy treatment of a supratentorial extradural or subdural hematoma; use 61154 when the surgeon uses burr-hole access.

61154 billing questions

How does this differ from a twist-drill drainage procedure?

This code describes evacuation or drainage of an extradural or subdural hematoma through burr-hole access. Code 61108 is for a twist-drill approach to subdural or intracerebral drainage.

Is each burr hole reported as a separate unit?

No. The code describes the hematoma procedure using one or more burr holes; the number of holes alone does not create separate units.

Can the burr-hole access be billed separately from hematoma drainage?

The access and the hematoma evacuation or drainage are represented together by this procedure code; do not report the access as a separate service.

How is bilateral performance reported?

Use modifier 50 for bilateral performance. CMS pays the bilateral procedure at 150%.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and related postoperative care through 90 days after surgery.

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

Show the CMS file lines behind this rate
RVUs for 61154PPRRVU2026_Oct_nonQPP.csv, line 6,751 (RVU26D)

Open CMS sourceHow we calculate rates

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