CPT code 61591: Skull-base approach, postauricular infratemporal route2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $3,059.72 for 61591 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 61591 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 61591 covers

This code represents a postauricular infratemporal route to the middle cranial fossa, generally used when a skull-base lesion requires access through the temporal bone from behind the ear. The operation may include petrous apicectomy and facial nerve mobilization, but the approach does not include resection of the internal auditory canal. Neurosurgeons and otolaryngologists with skull-base expertise may perform it, often in a hospital operating room and sometimes as part of a coordinated surgical team.

Select the code from the operative approach and documented work, not from the diagnosis alone. The report should identify the postauricular route and describe the bone work, facial nerve handling, and whether the internal auditory canal was resected. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the 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.

How Washington, DC area compares for 61591

Across 109 of 109 payment localities, the facility rate for 61591 runs from $2,474.03 in Arkansas to $3,432.83 in Alaska. Washington, DC area pays $3,059.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

61591 rates by state

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

See 61591 in every payment locality

How the 61591 rate is calculated

Each of 61591’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 61591

61591 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 61591

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

How 61591 has changed in Washington, DC area

Price 61591 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