CPT code 61590: Skull base approach, infratemporal, extradural2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $2,930.38 for 61590 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 61590 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 61590 covers

This code represents an extradural infratemporal approach to the middle cranial fossa, used to reach lesions at the skull base through the temporal bone region. The operation may involve substantial bone work and exposure around the petrous temporal bone. Neurosurgeons and otolaryngologists with skull base expertise commonly perform this type of approach in a hospital operating room for complex skull base lesions when the infratemporal route is required.

Report the approach when the operative note supports an infratemporal route and an extradural surgical plane; distinguish it from an intradural approach or a different skull base corridor. Documentation should identify the target, route, extent of exposure and relevant bone work. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.

How Washington, DC area compares for 61590

Across 109 of 109 payment localities, the facility rate for 61590 runs from $2,400.47 in Arkansas to $3,347.88 in Alaska. Washington, DC area pays $2,930.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

61590 rates by state

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

See 61590 in every payment locality

How the 61590 rate is calculated

Each of 61590’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.

Payment rules and modifiers for 61590

61590 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 61590

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

How 61590 has changed in Washington, DC area

Price 61590 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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

Open CMS sourceHow we calculate rates