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CPT code 61605: Skull-base resection, middle fossa, extradural2026 Medicare rate & RVUs

Reports surgical removal of a lesion in the extradural space of the middle cranial fossa, with dural repair included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities485 Medicare services in 2024

Medicare pays $1,912.54 for 61605 nationally in a facility.

Medicare rate · 61605

Skull-base resection, middle fossa, extradural

Office or facility?

Work RVUs
31.76
Total RVUs
57.26
Global days
090

National rate · 2026

$1,912.54

Facility setting, before claim adjustments.

See every locality for 61605 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 61605 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 61605 covers

This service covers surgical resection or excision of a neoplastic, vascular, or infectious lesion in the middle cranial fossa when the operative work is extradural. A neurosurgeon, often working with a skull-base team, performs the procedure in an operating room. The operative report should identify the lesion’s location and document that the work was extradural; the diagnosis alone does not establish the anatomic site or surgical plane. Dural repair, with or without a graft, is part of the service.

Select this code for the middle cranial fossa extradural location, rather than a different cranial fossa or an intradural procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; 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 61605 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

61605 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,748.58
AlaskaUnavailable$2,402.68
ArizonaUnavailable$1,865.11
ArkansasUnavailable$1,728.44
Atlanta, GAUnavailable$1,963.76
Austin, TXUnavailable$1,932.06
Bakersfield, CAUnavailable$1,923.85
Baltimore area, MDUnavailable$2,022.20
Beaumont, TXUnavailable$1,839.42
Brazoria, TXUnavailable$1,874.10

61605 rates by state

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

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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
61605 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 61605 rate is calculated

Each of 61605’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 · 61605

RVUs × geographic indexes × conversion factor

Office or facility?

Work31.76

31.76 RVUs× 1.000 GPCI

Practice expense19.93

19.93 RVUs× 1.000 GPCI

Malpractice5.57

5.57 RVUs× 1.000 GPCI

Adjusted RVUs

57.2600

Conversion factor

$33.4009

Medicare rate

$1,912.54

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 61605

61605 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61605

Skull-base resection, middle fossa, extradural

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)2Permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 61605

Skull-base resection, middle fossa, extradural

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

61605 without 51 · national facility

$1,912.54

Skull-base resection, middle fossa, extradural

61605-51 · Second procedure: 50%

$956.27

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

61605 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 61605

    Skull-base resection, middle fossa, extradural31.76 wRVU

    Not priced

  • 61606

    Skull-base lesion resection, posterior fossa, extradural41 wRVU

    Not priced

  • 61600

    Skull base resection, anterior fossa, extradural29.26 wRVU

    Not priced

  • 61607

    Cranial lesion resection, posterior fossa, extradural39.91 wRVU

    Not priced

How to choose

61606Skull-base lesion resectionPosterior fossa, extradural
Use 61605 for extradural resection in the middle cranial fossa; use 61606 when the lesion is treated intradurally in that fossa.
61600Skull base resectionAnterior fossa, extradural
This code is for the middle cranial fossa. Code 61600 is the corresponding extradural lesion-resection service for the anterior cranial fossa.
61607Cranial lesion resectionPosterior fossa, extradural
Both describe extradural lesion resection, but 61607 is for the posterior cranial fossa rather than the middle cranial fossa.

Codes related to 61605

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

Codes related to 61605
CodeHow it relatesNational office range
Same family
61600Skull base resection, anterior fossa, extraduralRelated lesion-resection code for the anterior cranial fossa rather than the middle cranial fossa.No office rate
61601Skull base resection, anterior fossa, intraduralAnterior cranial fossa sibling; the location differs from this middle-fossa service.No office rate
61606Skull-base lesion resection, posterior fossa, extraduralMiddle cranial fossa sibling for intradural rather than extradural operative work.No office rate
61607Cranial lesion resection, posterior fossa, extraduralPosterior cranial fossa extradural lesion-resection sibling.No office rate
61608Cranial lesion resection, posterior fossa, intraduralPosterior cranial fossa intradural lesion-resection sibling.No office rate

61605 billing questions

How does this differ from code 61606?

Both concern a middle cranial fossa lesion, but 61605 is for extradural operative work and 61606 is for intradural work. The operative report should support the compartment treated.

Is dural repair separately reported?

Dural repair, with or without a graft, is included in this lesion-resection service. The operative note should document the repair as part of the procedure.

What documentation supports this code?

Document the lesion’s middle cranial fossa location, its pathology when known, and the extradural surgical plane. Describe the resection and any dural repair performed.

How does the multiple-procedure reduction work?

For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is permitted.

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
RVUs for 61605PPRRVU2026_Oct_nonQPP.csv, line 6,837 (RVU26D)

Open CMS sourceHow we calculate rates

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