CPT code 61583: Craniofacial approach, middle fossa, intradural2026 Medicare rate & RVUs in Maryland
Reports a craniofacial route into the middle cranial fossa with intradural access, including elevation of the temporal lobe when needed.
CMS doesn’t publish an office rate for 61583 in Maryland.
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 61583 covers
This service provides a craniofacial route to the middle cranial fossa for intracranial work requiring intradural access. The operative exposure includes elevation of the temporal lobe when needed. Neurosurgeons commonly perform the intracranial portion with a craniofacial, otolaryngology, or reconstructive surgeon involved in the approach, depending on the case. It is generally performed in a hospital operating room for skull-base lesions or other pathology requiring this route.
Choose the code from the documented operative route and whether the work enters the dura, not from the lesion diagnosis alone. The operative report should describe the craniofacial exposure, middle-fossa access, and intradural work. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires 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 61583 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $3,149.72 |
| Rest of Maryland | Unavailable | $2,907.90 |
| Washington, DC area | Unavailable | $3,255.13 |
How the 61583 rate is calculated
Each of 61583’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 · 61583
RVUs × geographic indexes × conversion factor
Work37.54
37.54 RVUs× 1.000 GPCI
Practice expense34.62
34.62 RVUs× 1.000 GPCI
Malpractice15.37
15.37 RVUs× 1.000 GPCI
Adjusted RVUs
87.5300
Conversion factor
$33.4009
Medicare rate
$2,923.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61583
61583 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61583
Craniofacial approach, middle fossa, intradural
| 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 · 61583
Craniofacial approach, middle fossa, intradural
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
61583 without 51 · national facility
$2,923.58
Craniofacial approach, middle fossa, intradural
61583-51 · Second procedure: 50%
$1,461.79
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%).
61583 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61582Craniofacial approachSkull base surgery
- Both use a craniofacial route to the middle cranial fossa. 61583 is the intradural approach; 61582 is extradural.
- 61581Craniofacial approachAnterior cranial fossa
- Both are intradural craniofacial approaches, but 61581 accesses the anterior cranial fossa and 61583 the middle cranial fossa.
- 61590Skull base approachInfratemporal, extradural
- 61590 describes an infratemporal approach to the middle cranial fossa. Use 61583 when the operative route is craniofacial instead.
61583 billing questions
How does 61583 differ from 61582?
Both describe a craniofacial route to the middle cranial fossa. Choose 61583 when the approach is intradural; 61582 describes the extradural approach.
How does 61583 differ from 61581?
61583 is for a middle cranial fossa approach, while 61581 is for an anterior cranial fossa approach. The operative site and route determine the distinction.
Does 61583 include removal of the lesion?
The code describes the craniofacial intradural approach and exposure. Report a definitive lesion procedure separately only when that distinct service is supported and separately reportable.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the described anatomy or service.
What documentation supports co-surgeon or team-surgery reporting?
Document each surgeon's distinct role and the work performed in the operative report. Co-surgeon payment requires supporting documentation; team surgery is permitted.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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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