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CPT code 61585: Orbitocranial approach, intradural, anterior cranial fossa2026 Medicare rate & RVUs

Reports an intradural orbitocranial route to the anterior cranial fossa when surgery requires access through the orbit and cranium.

CMS RVU26DEffective Oct 1, 2026109 payment localities20 Medicare services in 2024

Medicare pays $3,255.25 for 61585 nationally in a facility.

Medicare rate · 61585

Orbitocranial approach, intradural, anterior cranial fossa

Office or facility?

Work RVUs
41.51
Total RVUs
97.46
Global days
090

National rate · 2026

$3,255.25

Facility setting, before claim adjustments.

See every locality for 61585 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 61585 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 61585 covers

This code describes an operative route to the anterior cranial fossa that combines orbital and cranial access and enters the dura. Neurosurgeons and craniofacial teams may use this approach for lesions involving the anterior skull base and orbit, such as selected meningiomas. The operative approach is distinct from the definitive work on the lesion; the operative report should make the route and intradural access clear.

Report the code when the documented operation supports this intradural orbitocranial approach, rather than an extradural variant or a different skull-base route. It has a 90-day global period, including 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 others at 50%. Modifier 50 identifies bilateral surgery and is paid at 150%. 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 61585 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

61585 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,840.83
AlaskaUnavailable$3,769.17
ArizonaUnavailable$3,131.19
ArkansasUnavailable$2,790.45
Atlanta, GAUnavailable$3,397.57
Austin, TXUnavailable$3,265.76
Bakersfield, CAUnavailable$3,176.01
Baltimore area, MDUnavailable$3,509.83
Beaumont, TXUnavailable$3,098.18
Brazoria, TXUnavailable$3,126.05

61585 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
61585 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 61585 rate is calculated

Each of 61585’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 · 61585

RVUs × geographic indexes × conversion factor

Office or facility?

Work41.51

41.51 RVUs× 1.000 GPCI

Practice expense38.43

38.43 RVUs× 1.000 GPCI

Malpractice17.52

17.52 RVUs× 1.000 GPCI

Adjusted RVUs

97.4600

Conversion factor

$33.4009

Medicare rate

$3,255.25

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

Payment rules and modifiers for 61585

61585 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61585

Orbitocranial approach, intradural, anterior cranial fossa

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)2Permitted.
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 · 61585

Orbitocranial approach, intradural, anterior cranial fossa

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

61585 without 50 · national facility

$3,255.25

Orbitocranial approach, intradural, anterior cranial fossa

61585-50 · Bilateral: 150%

$4,882.88

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

61585 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 61585

    Orbitocranial approach, intradural, anterior cranial fossa41.51 wRVU

    Not priced

  • 61584

    Skull base approach, extradural, orbital osteotomy36.76 wRVU

    Not priced

  • 61592

    Skull base approach, orbitocranial zygomatic route42 wRVU

    Not priced

  • 61580

    Craniofacial approach, extradural anterior fossa33.65 wRVU

    Not priced

How to choose

61584Skull base approachExtradural, orbital osteotomy
Both describe an orbitocranial approach to the anterior cranial fossa. Choose 61585 for the intradural route and 61584 for the extradural route.
61592Skull base approachOrbitocranial zygomatic route
This is another orbitocranial approach code, but it addresses a different cranial fossa target. Select based on the documented operative route and target.
61580Craniofacial approachExtradural anterior fossa
61580 describes a craniofacial approach to the anterior cranial fossa; 61585 is the orbitocranial route with intradural access.

Codes related to 61585

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 61585
CodeHow it relatesNational office range
Same family
61584Skull base approach, extradural, orbital osteotomyOrbitocranial approach to the anterior cranial fossa using an extradural route.No office rate
61592Skull base approach, orbitocranial zygomatic routeOrbitocranial approach code for a different cranial fossa target.No office rate
Used instead
61580Craniofacial approach, extradural anterior fossaCraniofacial rather than orbitocranial access to the anterior cranial fossa.No office rate
61590Skull base approach, infratemporal, extraduralInfratemporal route to the middle cranial fossa rather than orbitocranial access.No office rate

61585 billing questions

How is this code distinguished from 61584?

61585 describes the intradural orbitocranial approach to the anterior cranial fossa. 61584 is the extradural approach.

Does this code describe removal of the lesion?

It identifies the operative approach, not the pathology or definitive lesion work. The operative report should support the approach, and any separately reported lesion procedure must be documented.

What documentation supports reporting 61585?

Document the anterior cranial fossa target, the orbitocranial route, and entry into the dura. The operative details should distinguish it from an extradural approach or another skull-base route.

How does the 90-day global period affect billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

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.

How is bilateral surgery handled?

For a bilateral procedure reported with modifier 50, CMS pays at 150%.

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 61585PPRRVU2026_Oct_nonQPP.csv, line 6,826 (RVU26D)

Open CMS sourceHow we calculate rates

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