CPT code 61619: Dural repair, skull base leak2026 Medicare rate & RVUs in California
Reports graft-based repair of a dural or cerebrospinal fluid leak involving the skull base, such as a defect causing cranial fluid drainage.
CMS doesn’t publish an office rate for 61619 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.
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What 61619 covers
This service repairs a dural defect or cerebrospinal fluid leak that involves the skull base, using a free tissue graft such as fascia, pericranium, fat, or muscle. Neurosurgeons and skull-base surgeons, including otolaryngologists working in a multidisciplinary team, may perform it in a hospital operating room. Clinical settings include repair of a skull-base leak associated with rhinorrhea or otorrhea, or closure of a skull-base dural defect encountered during surgery.
Report the code when the operative record supports a leak or defect involving the skull base and describes the graft-based repair. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate for this code. 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 61619 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
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,512.18 |
| Chico, CA | Unavailable | $1,488.53 |
| El Centro, CA | Unavailable | $1,490.05 |
| Fresno, CA | Unavailable | $1,488.53 |
| Hanford, CA | Unavailable | $1,488.53 |
| Los Angeles, CA | Unavailable | $1,591.85 |
| Madera, CA | Unavailable | $1,488.53 |
| Marin County, CA | Unavailable | $1,691.25 |
| Merced, CA | Unavailable | $1,488.53 |
| Modesto, CA | Unavailable | $1,488.53 |
| Napa, CA | Unavailable | $1,633.31 |
| Oxnard, CA | Unavailable | $1,569.48 |
| Redding, CA | Unavailable | $1,488.53 |
| Rest of California | Unavailable | $1,488.53 |
| Riverside, CA | Unavailable | $1,585.70 |
| Sacramento, CA | Unavailable | $1,538.48 |
| Salinas, CA | Unavailable | $1,532.71 |
| San Benito County, CA | Unavailable | $1,742.80 |
| San Diego, CA | Unavailable | $1,553.85 |
| San Francisco, CA | Unavailable | $1,680.90 |
| San Luis Obispo, CA | Unavailable | $1,511.81 |
| Santa Clara County, CA | Unavailable | $1,700.51 |
| Santa Cruz, CA | Unavailable | $1,555.84 |
| Santa Maria, CA | Unavailable | $1,534.34 |
| Santa Rosa, CA | Unavailable | $1,569.35 |
| Stockton, CA | Unavailable | $1,488.53 |
| Vallejo, CA | Unavailable | $1,618.40 |
| Visalia, CA | Unavailable | $1,488.53 |
| Yuba City, CA | Unavailable | $1,488.53 |
How the 61619 rate is calculated
Each of 61619’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 · 61619
RVUs × geographic indexes × conversion factor
Work21.55
21.55 RVUs× 1.000 GPCI
Practice expense16.21
16.21 RVUs× 1.000 GPCI
Malpractice9.11
9.11 RVUs× 1.000 GPCI
Adjusted RVUs
46.8700
Conversion factor
$33.4009
Medicare rate
$1,565.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61619
61619 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61619
Dural repair, skull base leak
| 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 · 61619
Dural repair, skull base leak
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
61619 without 51 · national facility
$1,565.50
Dural repair, skull base leak
61619-51 · Second procedure: 50%
$782.75
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%).
61619 compared with similar codes
Compare codes · National
61619 vs 61618 vs 62100: Medicare rates
How to choose
- 61618Dural leak repairCranial approach
- Both describe graft-based repair of a dural or cerebrospinal fluid leak. Choose 61619 when the leak involves the skull base; 61618 is for a leak that does not.
- 62100Brain fluid leak repairCraniotomy-based dural repair
- This code identifies graft-based repair of a leak involving the skull base. Code 62100 describes craniotomy for dural or cerebrospinal fluid leak repair; select according to the operative service documented.
61619 billing questions
How do I distinguish this code from 61618?
Use 61619 for a dural or cerebrospinal fluid leak involving the skull base. Code 61618 is the related repair code for a leak that does not involve the skull base.
What documentation supports reporting 61619?
Document the skull-base location, the dural defect or leak being repaired, and the free tissue graft used. The operative report should make clear that the repair addresses the leak or defect rather than merely describing routine closure.
Can modifier 50 be used for bilateral repair?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
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.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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