CPT code 61591: Skull-base approach, postauricular infratemporal route2026 Medicare rate & RVUs in New Mexico
Reports a postauricular infratemporal surgical route to the middle cranial fossa when operative access requires the specified skull-base approach and associated bone work.
In New Mexico, Medicare pays $2,782.40 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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $2,782.40. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$2,782.40
- Los Angeles, CA · California$2,875.46+$93.06
- Washington, DC area · District of Columbia$3,059.72+$277.32
- Miami, FL · Florida$3,389.60+$607.20
- Chicago, IL · Illinois$3,280.98+$498.58
- Manhattan, NY · New York$3,238.81+$456.41
- Alaska · Alaska$3,432.83+$650.43
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,507.16 |
| ArkansasArkansas | — | $2,474.03 |
| ArizonaArizona | — | $2,698.13 |
| Bakersfield, CACalifornia | — | $2,745.21 |
| Chico, CACalifornia | — | $2,714.72 |
| El Centro, CACalifornia | — | $2,716.60 |
| Fresno, CACalifornia | — | $2,714.72 |
| Hanford, CACalifornia | — | $2,714.72 |
| Madera, CACalifornia | — | $2,714.72 |
| Merced, CACalifornia | — | $2,714.72 |
| Modesto, CACalifornia | — | $2,714.72 |
| Napa, CACalifornia | — | $2,968.31 |
| Oxnard, CACalifornia | — | $2,839.28 |
| Redding, CACalifornia | — | $2,714.72 |
| Rest of CaliforniaCalifornia | — | $2,714.72 |
| Riverside, CACalifornia | — | $2,835.37 |
| Sacramento, CACalifornia | — | $2,802.26 |
| Salinas, CACalifornia | — | $2,791.12 |
| San Diego, CACalifornia | — | $2,824.12 |
| Marin County, CACalifornia | — | $3,079.15 |
| San Francisco, CACalifornia | — | $3,066.38 |
| San Benito County, CACalifornia | — | $3,158.97 |
| Santa Clara County, CACalifornia | — | $3,106.74 |
| San Luis Obispo, CACalifornia | — | $2,752.23 |
| Santa Cruz, CACalifornia | — | $2,824.66 |
| Santa Maria, CACalifornia | — | $2,792.63 |
| Santa Rosa, CACalifornia | — | $2,849.78 |
| Stockton, CACalifornia | — | $2,714.72 |
| Vallejo, CACalifornia | — | $2,949.90 |
| Visalia, CACalifornia | — | $2,714.72 |
| Yuba City, CACalifornia | — | $2,714.72 |
| ColoradoColorado | — | $2,771.21 |
| ConnecticutConnecticut | — | $2,956.00 |
| DelawareDelaware | — | $2,738.52 |
| Fort Lauderdale, FLFlorida | — | $3,094.24 |
| Rest of FloridaFlorida | — | $2,929.91 |
| Atlanta, GAGeorgia | — | $2,873.37 |
| Rest of GeorgiaGeorgia | — | $2,757.21 |
| Hawaii, Guam, HIHawaii | — | $2,740.62 |
| IowaIowa | — | $2,478.55 |
| IdahoIdaho | — | $2,511.47 |
| East St. Louis, ILIllinois | — | $3,090.52 |
| Rest of IllinoisIllinois | — | $2,914.94 |
| Suburban Chicago, ILIllinois | — | $3,103.65 |
| IndianaIndiana | — | $2,522.46 |
| KansasKansas | — | $2,509.16 |
| KentuckyKentucky | — | $2,650.51 |
| New Orleans, LALouisiana | — | $2,778.92 |
| Rest of LouisianaLouisiana | — | $2,663.18 |
| Metropolitan Boston, MAMassachusetts | — | $2,969.98 |
| Rest of MassachusettsMassachusetts | — | $2,773.75 |
| Baltimore area, MDMaryland | — | $2,956.53 |
| Rest of MarylandMaryland | — | $2,774.26 |
| Rest of MaineMaine | — | $2,567.46 |
| Southern Maine, MEMaine | — | $2,632.78 |
| Detroit, MIMichigan | — | $3,006.53 |
| Rest of MichiganMichigan | — | $2,751.86 |
| MinnesotaMinnesota | — | $2,540.05 |
| Metropolitan Kansas City, MOMissouri | — | $2,717.43 |
| Metropolitan St. Louis, MOMissouri | — | $2,738.16 |
| Rest of MissouriMissouri | — | $2,649.12 |
| MississippiMississippi | — | $2,559.95 |
| MontanaMontana | — | $2,778.54 |
| North CarolinaNorth Carolina | — | $2,585.19 |
| North DakotaNorth Dakota | — | $2,556.09 |
| NebraskaNebraska | — | $2,478.39 |
| New HampshireNew Hampshire | — | $2,768.09 |
| Northern New JerseyNew Jersey | — | $3,040.89 |
| Rest of New JerseyNew Jersey | — | $2,957.25 |
| NevadaNevada | — | $2,717.41 |
| NYC suburbs and Long Island, NYNew York | — | $3,364.20 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $3,009.98 |
| Queens, NYNew York | — | $3,202.15 |
| Rest of New YorkNew York | — | $2,624.07 |
| OhioOhio | — | $2,706.39 |
| OklahomaOklahoma | — | $2,602.14 |
| Portland, OROregon | — | $2,804.43 |
| Rest of OregonOregon | — | $2,664.20 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,915.14 |
| Rest of PennsylvaniaPennsylvania | — | $2,687.08 |
| Puerto RicoPuerto Rico | — | $2,783.25 |
| Rhode IslandRhode Island | — | $2,796.59 |
| South CarolinaSouth Carolina | — | $2,656.62 |
| South DakotaSouth Dakota | — | $2,529.78 |
| TennesseeTennessee | — | $2,525.92 |
| Austin, TXTexas | — | $2,790.12 |
| Beaumont, TXTexas | — | $2,674.09 |
| Brazoria, TXTexas | — | $2,701.02 |
| Dallas, TXTexas | — | $2,736.22 |
| Fort Worth, TXTexas | — | $2,732.38 |
| Galveston, TXTexas | — | $2,720.80 |
| Houston, TXTexas | — | $2,926.72 |
| Rest of TexasTexas | — | $2,698.35 |
| UtahUtah | — | $2,688.62 |
| VirginiaVirginia | — | $2,653.98 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,783.25 |
| VermontVermont | — | $2,584.94 |
| Rest of WashingtonWashington | — | $2,755.63 |
| King County, WAWashington | — | $2,985.12 |
| WisconsinWisconsin | — | $2,482.62 |
| West VirginiaWest Virginia | — | $2,826.95 |
| WyomingWyoming | — | $2,681.59 |
61591 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 61591
RVUs × geographic indexes × conversion factor
Work45.84
45.84 RVUs× 1.000 GPCI
Practice expense26.12
26.12 RVUs× 1.000 GPCI
Malpractice11.25
11.25 RVUs× 1.000 GPCI
Adjusted RVUs
83.2100
Conversion factor
$33.4009
Medicare rate
$2,779.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,829
- Code
- 61591
- Physician work
- 45.84
- Practice expense
- 26.12
- Malpractice
- 11.25
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 45.84 | × 1.000 | 45.8400 |
| Practice expense | 26.12 | × 0.917 | 23.9520 |
| Malpractice | 11.25 | × 1.201 | 13.5113 |
| Total RVUs | 83.3033 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$2782.40
Facility: (45.84 × 1 + 26.12 × 0.917 + 11.25 × 1.201) × $33.4009 = $2782.40
Payment rules and modifiers for 61591
61591 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61591
Skull-base approach, postauricular infratemporal route
| 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 · 61591
Skull-base approach, postauricular infratemporal route
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
61591 without 50 · national facility
$2,779.29
Skull-base approach, postauricular infratemporal route
61591-50 · Bilateral: 150%
$4,168.94
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).
How 61591 has changed in New Mexico
61591 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,782.40 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,782.40 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,782.40 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,782.40 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,954.32 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,954.32 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,954.32 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,954.32 | RVU25A |
| 2024-10-01 | Not available in this setting | $3,027.89 | RVU24D |
| 2024-07-01 | Not available in this setting | $3,027.89 | RVU24C |
| 2024-04-01 | Not available in this setting | $3,027.89 | RVU24B |
| 2024-03-09 | Not available in this setting | $3,027.89 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,978.47 | RVU24A |
| 2023-10-01 | Not available in this setting | $3,069.80 | RVU23D |
| 2023-07-01 | Not available in this setting | $3,069.80 | RVU23C |
| 2023-04-01 | Not available in this setting | $3,069.80 | RVU23B |
| 2023-01-01 | Not available in this setting | $3,069.80 | RVU23A |
| 2022-10-01 | Not available in this setting | $3,078.75 | RVU22D |
| 2022-07-01 | Not available in this setting | $3,078.75 | RVU22C |
| 2022-04-01 | Not available in this setting | $3,078.75 | RVU22B |
| 2022-01-01 | Not available in this setting | $3,078.75 | RVU22A |
| 2021-10-01 | Not available in this setting | $3,089.23 | RVU21D |
| 2021-07-01 | Not available in this setting | $3,089.23 | RVU21C |
| 2021-04-01 | Not available in this setting | $3,089.23 | RVU21B |
| 2021-01-01 | Not available in this setting | $3,089.23 | RVU21A |
| 2020-10-01 | Not available in this setting | $3,165.25 | RVU20D |
| 2020-07-01 | Not available in this setting | $3,165.25 | RVU20C |
| 2020-04-01 | Not available in this setting | $3,165.25 | RVU20B |
| 2020-01-01 | Not available in this setting | $3,165.25 | RVU20A |
| 2019-10-01 | Not available in this setting | $3,216.79 | RVU19D |
| 2019-07-01 | Not available in this setting | $3,216.79 | RVU19C |
| 2019-04-01 | Not available in this setting | $3,216.79 | RVU19B |
| 2019-01-01 | Not available in this setting | $3,216.79 | RVU19A |
| 2018-10-01 | Not available in this setting | $3,182.89 | RVU18D |
| 2018-07-01 | Not available in this setting | $3,182.89 | RVU18C |
| 2018-04-01 | Not available in this setting | $3,182.89 | RVU18B |
| 2018-01-01 | Not available in this setting | $3,182.89 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $3,183.65 | RVU17D |
| 2017-07-01 | Not available in this setting | $3,183.65 | RVU17C |
| 2017-04-01 | Not available in this setting | $3,183.65 | RVU17B |
| 2017-01-01 | Not available in this setting | $3,183.65 | RVU17A |
| 2016-10-01 | Not available in this setting | $3,200.44 | RVU16D |
| 2016-07-01 | Not available in this setting | $3,200.44 | RVU16C |
| 2016-04-01 | Not available in this setting | $3,200.44 | RVU16B |
| 2016-01-01 | Not available in this setting | $3,200.44 | RVU16A |
| 2015-10-01 | Not available in this setting | $3,225.83 | RVU15D |
| 2015-07-01 | Not available in this setting | $3,225.83 | RVU15C |
| 2015-04-01 | Not available in this setting | $3,209.78 | RVU15B |
| 2015-01-01 | Not available in this setting | $3,209.78 | RVU15A |
| 2014-10-01 | Not available in this setting | $3,119.50 | RVU14D |
| 2014-07-01 | Not available in this setting | $3,119.50 | RVU14C |
| 2014-04-01 | Not available in this setting | $3,119.50 | RVU14B |
| 2014-01-01 | Not available in this setting | $3,119.50 | RVU14A |
| 2013-10-01 | Not available in this setting | $3,039.87 | RVU13D |
| 2013-07-01 | Not available in this setting | $3,039.87 | RVU13C |
| 2013-04-01 | Not available in this setting | $3,039.87 | RVU13B |
| 2013-01-01 | Not available in this setting | $3,039.87 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
61591 billing questions
How does 61591 differ from 61590?
Both describe infratemporal routes to the middle cranial fossa. 61591 is the postauricular approach; 61590 describes the preauricular approach.
What operative details support reporting 61591?
Document the postauricular route and the skull-base access performed, including relevant petrous bone work and facial nerve mobilization. The internal auditory canal is not resected with this approach code.
Does 61591 include removal of the skull-base lesion?
The code identifies the approach and associated access work, rather than establishing that every lesion resection is included. Code any separately reportable definitive procedure only when the operative work and applicable CPT instructions support it.
How is 61591 paid when another procedure is performed in the same session?
Under the standard multiple procedure rule, the highest-valued procedure is paid in full and other procedures are paid at 50%. The 90-day global includes the day-before preoperative visit and related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and CMS permits team surgery.
When is modifier 50 appropriate for 61591?
Use modifier 50 when the documented procedure is bilateral. CMS pays a bilateral procedure reported with modifier 50 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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