CPT code 61595: Skull base approach, transtemporal route2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 61595 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.

What 61595 covers

This code describes surgical access through the temporal bone toward the posterior cranial fossa, jugular foramen, or midline skull base. The approach includes mastoidectomy and decompression of the facial nerve, with or without facial nerve mobilization. It is typically performed in an operating room by an otologic or skull-base surgeon, often working with a neurosurgeon, to expose a lesion or other surgical target in these regions.

Report the approach when the operative record identifies the transtemporal route and supports the included bone and facial nerve work; the code represents access, not removal of the lesion. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, payment is 150%. Assistant-at-surgery payment is barred by statutory restriction; 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 61595 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

How the 61595 rate is calculated

Each of 61595’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 61595

61595 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

61595 compared with similar codes

How to choose

61596Skull base approachTranscochlear posterior fossa

61595 describes a transtemporal approach with mastoidectomy and facial nerve decompression. 61596 is the transcochlear approach.

61597Skull-base approachTranscondylar route

Use 61595 for the transtemporal route; 61597 identifies a transcondylar route to the posterior fossa.

61590Skull base approachInfratemporal, extradural

61590 describes an infratemporal preauricular route to the middle cranial fossa, rather than the transtemporal route represented by 61595.

Codes related to 61595

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

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