FeeBase
Log inGet started
Menu

Billing code 61345: Cranial decompressionMedicare rate & RVUs

Reports cranial surgery to decompress the posterior fossa when the operative service is not described by a more specific decompression code.

CMS RVU26DEffective Oct 1, 2026109 payment localities64 Medicare services in 2024

Medicare pays $1,989.69 for 61345 nationally in a facility.

Medicare rate · 61345

Cranial decompression

Swap in your local Medicare rate.

Work RVUs
28.5
Total RVUs
59.57
Global days
090

National rate · 2026

$1,989.69

Facility setting, before claim adjustments.

See every locality for 61345 → · 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 61345 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 61345 covers

A neurosurgeon performs an open cranial procedure to relieve pressure or crowding in the posterior fossa, the space containing the cerebellum and brainstem. The operation involves removing cranial bone to create room for the affected structures. It is performed in an operating room, typically in a hospital, for a documented posterior fossa decompression that does not fit a more specifically defined procedure, such as a named suboccipital decompression.

Select the code from the operative report’s documented site and work, not from the diagnosis alone. Documentation should identify the posterior fossa and explain the decompressive procedure performed. CMS assigns 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 other procedures are subject to the standard multiple-procedure reduction. 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 61345 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

61345 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,735.71
Alaska*Unavailable$2,326.41
ArizonaUnavailable$1,912.08
ArkansasUnavailable$1,705.03
AtlantaUnavailable$2,083.55
AustinUnavailable$1,982.62
BakersfieldUnavailable$1,911.56
Baltimore/Surr. CntysUnavailable$2,146.63
BeaumontUnavailable$1,903.93
BrazoriaUnavailable$1,903.11

61345 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
61345 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 61345 rate is calculated

Each of 61345’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 · 61345

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 28.50Practice expense 19.03Malpractice 12.04

59.5700 adjusted RVUs×$33.4009 conversion factor=$1,989.69

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

Payment rules and modifiers for 61345

61345 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61345

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 · 61345

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

61345 without 51 · national facility

$1,989.69

Cranial decompression

61345-51 · Second procedure: 50%

$994.85

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

61345 compared with similar codes

Compare codes

61345 vs 61343 vs 61340 vs 61322 vs 61305: national Medicare rates

Swap in your local Medicare rate.

  • 61345
    Cranial decompression · 28.5 wRVU
    —
  • 61343
    Posterior fossa decompression · 31.06 wRVU
    —
  • 61340
    Cranial decompression · 19.61 wRVU
    —
  • 61322
    Cranial decompression · 33.4 wRVU
    —
  • 61305
    Cranial exploration · 27.92 wRVU
    —

How to choose

61343Posterior fossa decompression
61343 describes a specific suboccipital decompression of the medulla or spinal cord. Use 61345 for another posterior fossa decompression not represented by that specific service.
61340Cranial decompression
61340 identifies decompression through a subtemporal approach. This code concerns other posterior fossa decompression.
61322Cranial decompression
61322 is for pressure decompression at a supratentorial site without lobectomy. This code is for decompression in the posterior fossa.
61305Cranial exploration
61305 describes infratentorial exploration, rather than a posterior fossa decompression. Choose based on the operation documented, not simply the anatomic region.

Codes related to 61345

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

Codes related to 61345
CodeHow it relatesNational office range
Same family
61343Posterior fossa decompressionMore specifically describes suboccipital decompression of the medulla or spinal cord.No office rate
61340Cranial decompressionCranial decompression performed through a subtemporal approach.No office rate
61322Cranial decompressionPressure decompression at a supratentorial site, without lobectomy.No office rate
61323Cranial decompressionPressure decompression at a supratentorial site, with lobectomy.No office rate

61345 billing questions

How does this differ from 61343?

Use 61343 when the documented procedure is the specifically described suboccipital decompression of the medulla or spinal cord. This code is for another posterior fossa decompression not captured by that more specific service.

Can the diagnosis alone support this code?

No. The operative report should establish that a posterior fossa decompression was performed and describe the work sufficiently to distinguish it from a more specifically defined procedure.

Are related postoperative visits included?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other same-session procedures paid?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not 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 61345PPRRVU2026_Oct_nonQPP.csv, line 6,772 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 61345 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 61345 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →