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Billing code 61322: Cranial decompressionMedicare rate & RVUs

Reports cranial decompression to relieve dangerous intracranial pressure from cerebral swelling when the operation does not include removal of a brain lobe.

CMS RVU26DEffective Oct 1, 2026109 payment localities858 Medicare services in 2024

Medicare pays $2,303.66 for 61322 nationally in a facility.

Medicare rate · 61322

Cranial decompression

Swap in your local Medicare rate.

Work RVUs
33.4
Total RVUs
68.97
Global days
090

National rate · 2026

$2,303.66

Facility setting, before claim adjustments.

See every locality for 61322 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 61322 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 61322 covers

A neurosurgeon opens or removes part of the skull to create room for a swollen brain and reduce intracranial pressure. The operation may include opening or expanding the dura, but it does not include removal of a brain lobe. Typical situations include severe traumatic brain injury or a large cerebral infarction with dangerous swelling despite medical treatment. These operations are generally performed in a hospital operating room.

Report the code when the operative record supports decompression without lobectomy; document the indication, operative site and extent, dural work, and any brain tissue removed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not 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 61322 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

61322 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,010.25
Alaska*Unavailable$2,697.64
ArizonaUnavailable$2,213.84
ArkansasUnavailable$1,974.82
AtlantaUnavailable$2,412.77
AustinUnavailable$2,294.14
BakersfieldUnavailable$2,210.53
Baltimore/Surr. CntysUnavailable$2,485.15
BeaumontUnavailable$2,205.64
BrazoriaUnavailable$2,202.94

61322 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
61322 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 61322 rate is calculated

Each of 61322’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 · 61322

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 33.40Practice expense 21.53Malpractice 14.04

68.9700 adjusted RVUs×$33.4009 conversion factor=$2,303.66

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 61322

61322 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61322

Cranial decompression

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)0Not permitted.
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 · 61322

Cranial decompression

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

61322 without 51 · national facility

$2,303.66

Cranial decompression

61322-51 · Second procedure: 50%

$1,151.83

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

61322 compared with similar codes

Compare codes

61322 vs 61323 vs 61312 vs 61314: national Medicare rates

Swap in your local Medicare rate.

  • 61322
    Cranial decompression · 33.4 wRVU
    —
  • 61323
    Cranial decompression · 34.18 wRVU
    —
  • 61312
    Hematoma evacuation · 29.42 wRVU
    —
  • 61314
    Hematoma evacuation · 25.25 wRVU
    —

How to choose

61323Cranial decompression
Use 61322 when decompression is performed without lobectomy. Use 61323 when the operation includes removal of a brain lobe.
61312Hematoma evacuation
61312 describes evacuation of a supratentorial extradural or subdural hematoma. This code describes decompression without lobectomy, not hematoma evacuation alone.
61314Hematoma evacuation
61314 describes evacuation of an infratentorial extradural or subdural hematoma. This code is for decompression without lobectomy.

Codes related to 61322

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

Codes related to 61322
CodeHow it relatesNational office range
Same family
61323Cranial decompressionRelated decompression code when the operation includes lobectomy.No office rate
Used instead
61312Hematoma evacuationTreats supratentorial extradural or subdural hematoma by evacuation rather than decompression for diffuse swelling.No office rate
61314Hematoma evacuationTreats infratentorial extradural or subdural hematoma by evacuation rather than decompression for diffuse swelling.No office rate

61322 billing questions

How does this differ from 61323?

The key distinction is whether the operation includes removal of a brain lobe. This code is for decompression without lobectomy; 61323 is the related option when lobectomy is performed.

Can dural expansion be part of this service?

Yes. The decompression may include work to expand the dura; that alone does not make the operation a different code.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply because the service’s descriptor or anatomy makes modifier 50 inappropriate.

What documentation supports reporting the code?

Document the pressure-relief indication, the cranial site and extent of decompression, dural work, and whether brain tissue was removed. The record should make clear that the operation did not include lobectomy.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

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 61322PPRRVU2026_Oct_nonQPP.csv, line 6,766 (RVU26D)

Open CMS sourceHow we calculate rates

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