CPT code 61322: Cranial decompression, without lobectomy2026 Medicare rate & RVUs in Guam
Reports cranial decompression to relieve dangerous intracranial pressure from cerebral swelling when the operation does not include removal of a brain lobe.
CMS doesn’t publish an office rate for 61322 in Guam.
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 9 sections
What 61322 covers
A neurosurgeon opens or removes part of the skull to create room for a swollen brain and reduce intracranial pressure. The operation may include opening or expanding the dura, but it does not include removal of a brain lobe. Typical situations include severe traumatic brain injury or a large cerebral infarction with dangerous swelling despite medical treatment. These operations are generally performed in a hospital operating room.
Report the code when the operative record supports decompression without lobectomy; document the indication, operative site and extent, dural work, and any brain tissue removed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 for this service. An assistant at surgery may be paid; co-surgeon payment requires 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.
61322 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $2,204.75 |
How the 61322 rate is calculated
Each of 61322’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 · 61322
RVUs × geographic indexes × conversion factor
Work33.40
33.40 RVUs× 1.000 GPCI
Practice expense21.53
21.53 RVUs× 1.000 GPCI
Malpractice14.04
14.04 RVUs× 1.000 GPCI
Adjusted RVUs
68.9700
Conversion factor
$33.4009
Medicare rate
$2,303.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61322
61322 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61322
Cranial decompression, without lobectomy
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 61322
Cranial decompression, without lobectomy
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
61322 without 51 · national facility
$2,303.66
Cranial decompression, without lobectomy
61322-51 · Second procedure: 50%
$1,151.83
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%).
61322 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61323Cranial decompressionWith lobectomy
- Use 61322 when decompression is performed without lobectomy. Use 61323 when the operation includes removal of a brain lobe.
- 61312Hematoma evacuationSupratentorial, extra- or subdural
- 61312 describes evacuation of a supratentorial extradural or subdural hematoma. This code describes decompression without lobectomy, not hematoma evacuation alone.
- 61314Hematoma evacuationInfratentorial, extradural or subdural
- 61314 describes evacuation of an infratentorial extradural or subdural hematoma. This code is for decompression without lobectomy.
61322 billing questions
How does this differ from 61323?
The key distinction is whether the operation includes removal of a brain lobe. This code is for decompression without lobectomy; 61323 is the related option when lobectomy is performed.
Can dural expansion be part of this service?
Yes. The decompression may include work to expand the dura; that alone does not make the operation a different code.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply because the service’s descriptor or anatomy makes modifier 50 inappropriate.
What documentation supports reporting the code?
Document the pressure-relief indication, the cranial site and extent of decompression, dural work, and whether brain tissue was removed. The record should make clear that the operation did not include lobectomy.
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
Show the CMS file lines behind this rate
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