CPT code 61582: Craniofacial approach, skull base surgery2026 Medicare rate & RVUs in Texas
Reports a craniofacial route to the skull base when surgery requires combined facial and cranial exposure for an anterior cranial fossa lesion.
CMS doesn’t publish an office rate for 61582 in Texas.
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 61582 covers
This code represents a craniofacial approach to the skull base, combining facial and cranial exposure to reach a lesion involving the anterior cranial fossa. A neurosurgeon may work with an otolaryngologist or a facial plastic surgeon when a tumor, such as an anterior skull base malignancy, requires access from both sides of the skull base. The service is generally performed in a hospital operating room and involves substantially more than a routine craniotomy or an isolated sinonasal tumor removal.
Report 61582 when the operative report supports the specific approach and work described by this code; use the complete code descriptor to distinguish it from related craniofacial approach codes. Documentation should identify the lesion, route of access, intracranial work, and surgeons’ roles. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is 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 61582 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $3,114.25 |
| Beaumont, TX | Unavailable | $2,912.15 |
| Brazoria, TX | Unavailable | $2,973.96 |
| Dallas, TX | Unavailable | $3,017.76 |
| Fort Worth, TX | Unavailable | $3,008.82 |
| Galveston, TX | Unavailable | $2,998.61 |
| Houston, TX | Unavailable | $3,246.26 |
| Rest of Texas | Unavailable | $2,958.18 |
How the 61582 rate is calculated
Each of 61582’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 · 61582
RVUs × geographic indexes × conversion factor
Work34.26
34.26 RVUs× 1.000 GPCI
Practice expense44.35
44.35 RVUs× 1.000 GPCI
Malpractice13.53
13.53 RVUs× 1.000 GPCI
Adjusted RVUs
92.1400
Conversion factor
$33.4009
Medicare rate
$3,077.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61582
61582 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61582
Craniofacial approach, skull base surgery
| 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) | 2 | 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 · 61582
Craniofacial approach, skull base surgery
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
61582 without 51 · national facility
$3,077.56
Craniofacial approach, skull base surgery
61582-51 · Second procedure: 50%
$1,538.78
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%).
61582 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61580Craniofacial approachExtradural anterior fossa
- Both describe craniofacial skull approaches. Select between them using the full descriptors and the approach and operative work documented in the report.
- 61581Craniofacial approachAnterior cranial fossa
- This is a sibling craniofacial approach code. The operative report must support the specific variant represented by the selected code.
- 61583Craniofacial approachMiddle fossa, intradural
- This is another craniofacial approach code; distinguish it from 61582 by matching the complete descriptor to the documented operative configuration.
- 61584Skull base approachExtradural, orbital osteotomy
- 61584 describes an orbitocranial route. Use 61582 when the documented approach matches its craniofacial skull-base work instead.
61582 billing questions
When should 61582 be chosen over another craniofacial approach code?
Choose it when the documented approach and operative work match 61582’s full descriptor. Compare the complete descriptors for 61580, 61581, and 61583 rather than relying on their abbreviated labels.
Can the cranial and facial portions be reported separately?
61582 represents a craniofacial approach, so the operative report should support the combined route and work. Do not treat its component exposures as separate services solely because different surgeons performed them.
Is modifier 50 appropriate when the approach is bilateral?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is permitted.
What postoperative care is included in the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
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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