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Billing code 61450: Cranial nerve sectionMedicare rate & RVUs

Reports a suboccipital craniectomy performed to intentionally section cranial nerve tissue, such as for selected cases of refractory cranial neuralgia.

CMS RVU26DEffective Oct 1, 2026109 payment localities25 Medicare services in 2024

Medicare pays $1,865.77 for 61450 nationally in a facility.

Medicare rate · 61450

Cranial nerve section

Swap in your local Medicare rate.

Work RVUs
27
Total RVUs
55.86
Global days
090

National rate · 2026

$1,865.77

Facility setting, before claim adjustments.

See every locality for 61450 → · 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 61450 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 61450 covers

The surgeon removes bone beneath the back of the skull to reach and intentionally divide one or more cranial nerves. This approach may be used for selected patients with severe, refractory cranial neuralgia when nerve section is the planned treatment. The operative report should identify the nerve or nerves treated and describe the sectioning performed; exploration or decompression without nerve section is a different service. Neurosurgeons typically perform this procedure in a hospital operating room.

Report 61450 when the documented work matches suboccipital access and cranial nerve section, rather than exploration or decompression alone. 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 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 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 61450 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

61450 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,627.52
Alaska*Unavailable$2,183.46
ArizonaUnavailable$1,792.83
ArkansasUnavailable$1,598.76
AtlantaUnavailable$1,954.41
AustinUnavailable$1,857.94
BakersfieldUnavailable$1,789.85
Baltimore/Surr. CntysUnavailable$2,013.07
BeaumontUnavailable$1,786.26
BrazoriaUnavailable$1,783.90

61450 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
61450 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 61450 rate is calculated

Each of 61450’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 · 61450

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 27.00Practice expense 17.45Malpractice 11.41

55.8600 adjusted RVUs×$33.4009 conversion factor=$1,865.77

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

Payment rules and modifiers for 61450

61450 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61450

Cranial nerve section

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 · 61450

Cranial nerve section

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

61450 without 51 · national facility

$1,865.77

Cranial nerve section

61450-51 · Second procedure: 50%

$932.89

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

61450 compared with similar codes

Compare codes

61450 vs 61458 vs 61460 vs 61790: national Medicare rates

Swap in your local Medicare rate.

  • 61450
    Cranial nerve section · 27 wRVU
    —
  • 61458
    Nerve decompression · 28.12 wRVU
    —
  • 61460
    Cranial nerve surgery · 29.48 wRVU
    —
  • 61790
    Trigeminal nerve treatment · 11.31 wRVU
    —

How to choose

61458Nerve decompression
Use 61450 when the surgeon intentionally sections cranial nerve tissue through a suboccipital approach. Use 61458 for cranial nerve exploration or decompression.
61460Cranial nerve surgery
This is a related suboccipital cranial nerve procedure with a distinct descriptor. Match code selection to the specific nerve procedure and extent documented in the operative report.
61790Trigeminal nerve treatment
61790 represents percutaneous stereotactic radiofrequency lesioning, a different approach that may address selected trigeminal neuralgia cases; 61450 involves suboccipital surgery and nerve section.

Codes related to 61450

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

Codes related to 61450
CodeHow it relatesNational office range
Same family
61458Nerve decompressionSuboccipital cranial nerve exploration or decompression rather than section.No office rate
61460Cranial nerve surgeryA related suboccipital cranial nerve procedure; select by the documented operative service.No office rate
Used instead
61790Trigeminal nerve treatmentPercutaneous stereotactic radiofrequency lesioning may be used for selected trigeminal neuralgia cases.No office rate

61450 billing questions

How does 61450 differ from 61458?

61450 describes suboccipital surgery that sections cranial nerve tissue. 61458 is for suboccipital exploration or decompression of cranial nerves, not nerve section.

Is the suboccipital bone removal separately reported?

The craniectomy is part of the service represented by 61450. Do not report a separate craniectomy code for the same operative access.

Should modifier 50 be used for bilateral nerve section?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the documented operative work.

What documentation supports 61450?

The operative report should establish the suboccipital approach and intentional sectioning of one or more cranial nerves, identifying the treated nerve or nerves.

Can an assistant surgeon or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

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 61450PPRRVU2026_Oct_nonQPP.csv, line 6,773 (RVU26D)

Open CMS sourceHow we calculate rates

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