CPT code 61616: Skull-base resection, intradural lesion2026 Medicare rate & RVUs in Missouri
Reports operative removal of an intradural skull-base lesion when the documented site and operative details support this skull-base resection code.
CMS doesn’t publish an office rate for 61616 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 61616 covers
A neurosurgeon or skull-base surgeon uses this code for operative removal of a lesion involving the skull base with work on the intradural side. Examples of skull-base lesions include meningiomas and schwannomas, but the operative anatomy and dural relationship—not the diagnosis alone—guide code selection. These procedures are generally performed in a hospital operating room, sometimes with neurosurgery and otolaryngology surgeons working together.
The operative report should identify the lesion, its skull-base location, its relationship to the dura, the approach, and the work performed. Distinguish this intradural service from the extradural counterpart, 61615, and from codes for specified cranial fossae. This major surgery 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 the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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.
Where 61616 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $3,076.96 |
| Metropolitan St. Louis, MO | Unavailable | $3,104.89 |
| Rest of Missouri | Unavailable | $2,992.50 |
How the 61616 rate is calculated
Each of 61616’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 · 61616
RVUs × geographic indexes × conversion factor
Work45.57
45.57 RVUs× 1.000 GPCI
Practice expense32.19
32.19 RVUs× 1.000 GPCI
Malpractice16.71
16.71 RVUs× 1.000 GPCI
Adjusted RVUs
94.4700
Conversion factor
$33.4009
Medicare rate
$3,155.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61616
61616 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61616
Skull-base resection, intradural lesion
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 61616
Skull-base resection, intradural lesion
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 51 · payment effect
With and without the modifier
61616 without 51 · national facility
$3,155.38
Skull-base resection, intradural lesion
61616-51 · Second procedure: 50%
$1,577.69
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%).
61616 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61615Skull lesion surgeryExtradural, with craniectomy
- Use 61615 for an extradural skull-base lesion; 61616 is the intradural counterpart. The operative report should establish the lesion's relationship to the dura.
- 61600Skull base resectionAnterior fossa, extradural
- 61600 addresses lesion resection at the anterior cranial fossa. Choose between it and 61616 based on the documented site and applicable operative anatomy.
- 61605Skull-base resectionMiddle fossa, extradural
- 61605 addresses lesion resection at the middle cranial fossa. The specific operative site helps distinguish it from the broader skull-base service represented by 61616.
- 61607Cranial lesion resectionPosterior fossa, extradural
- 61607 addresses lesion resection at the posterior cranial fossa. Use the code whose documented site and descriptor match the procedure performed.
61616 billing questions
How does 61616 differ from 61615?
The key distinction is whether the skull-base lesion is intradural or extradural. The operative report should support the lesion's relationship to the dura and the work performed.
How do I choose between 61616 and codes 61600 through 61608?
Those codes address lesions at specified cranial fossae. Select the code that matches the documented operative site and applicable code descriptor rather than relying on the diagnosis alone.
Can dural repair be reported separately?
A separate repair code may be relevant when a distinct repair service is performed and supported by the operative documentation. Code 61618 is associated with repair of a skull-base dural defect.
What documentation supports assistant or co-surgeon billing?
The operative record should show the surgeons' roles and the work each performed. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
Does the 90-day global period include postoperative visits?
It includes related postoperative care for 90 days and the preoperative visit on the day before surgery. The global period applies to this major surgical service.
Can modifier 50 be used for bilateral work?
No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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
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