CPT code 61585: Orbitocranial approach, intradural, anterior cranial fossa2026 Medicare rate & RVUs in California
Reports an intradural orbitocranial route to the anterior cranial fossa when surgery requires access through the orbit and cranium.
CMS doesn’t publish an office rate for 61585 in California.
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 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 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
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $3,176.01 |
| Chico, CA | Unavailable | $3,130.52 |
| El Centro, CA | Unavailable | $3,133.45 |
| Fresno, CA | Unavailable | $3,130.52 |
| Hanford, CA | Unavailable | $3,130.52 |
| Los Angeles, CA | Unavailable | $3,350.37 |
| Madera, CA | Unavailable | $3,130.52 |
| Marin County, CA | Unavailable | $3,596.66 |
| Merced, CA | Unavailable | $3,130.52 |
| Modesto, CA | Unavailable | $3,130.52 |
| Napa, CA | Unavailable | $3,462.87 |
| Oxnard, CA | Unavailable | $3,307.07 |
| Redding, CA | Unavailable | $3,130.52 |
| Rest of California | Unavailable | $3,130.52 |
| Riverside, CA | Unavailable | $3,317.41 |
| Sacramento, CA | Unavailable | $3,242.87 |
| Salinas, CA | Unavailable | $3,230.80 |
| San Benito County, CA | Unavailable | $3,703.59 |
| San Diego, CA | Unavailable | $3,280.42 |
| San Francisco, CA | Unavailable | $3,576.76 |
| San Luis Obispo, CA | Unavailable | $3,185.72 |
| Santa Clara County, CA | Unavailable | $3,622.25 |
| Santa Cruz, CA | Unavailable | $3,288.82 |
| Santa Maria, CA | Unavailable | $3,235.62 |
| Santa Rosa, CA | Unavailable | $3,317.98 |
| Stockton, CA | Unavailable | $3,130.52 |
| Vallejo, CA | Unavailable | $3,434.20 |
| Visalia, CA | Unavailable | $3,130.52 |
| Yuba City, CA | Unavailable | $3,130.52 |
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
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
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 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.
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).
61585 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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