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Billing code 61521: Brain lesion removalMedicare rate & RVUs

Reports craniectomy to remove a nonmeningioma tumor in the cerebellopontine angle, such as a vestibular schwannoma, through an infratentorial approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities94 Medicare services in 2024

Medicare pays $3,010.76 for 61521 nationally in a facility.

Medicare rate · 61521

Brain lesion removal

Swap in your local Medicare rate.

Work RVUs
45.82
Total RVUs
90.14
Global days
090

National rate · 2026

$3,010.76

Facility setting, before claim adjustments.

See every locality for 61521 → · 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 61521 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 61521 covers

This code describes an infratentorial craniectomy to remove a brain tumor in the cerebellopontine angle, the region between the cerebellum and pons. A typical clinical example is removal of a vestibular schwannoma through a suboccipital approach. A neurosurgeon performs the operation in a hospital operating room; the operative report should establish the tumor site, pathology or suspected diagnosis, and surgical approach.

Select the code based on the documented location and operative work, distinguishing a cerebellopontine angle tumor from other infratentorial tumors and from meningioma, abscess, or cyst procedures. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one 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 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 61521 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

61521 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,631.37
Alaska*Unavailable$3,548.92
ArizonaUnavailable$2,893.80
ArkansasUnavailable$2,585.68
AtlantaUnavailable$3,155.39
AustinUnavailable$2,991.50
BakersfieldUnavailable$2,875.65
Baltimore/Surr. CntysUnavailable$3,246.45
BeaumontUnavailable$2,889.48
BrazoriaUnavailable$2,876.97

61521 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
61521 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 61521 rate is calculated

Each of 61521’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 · 61521

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 45.82Practice expense 25.49Malpractice 18.83

90.1400 adjusted RVUs×$33.4009 conversion factor=$3,010.76

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

Payment rules and modifiers for 61521

61521 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61521

Brain lesion removal

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 · 61521

Brain lesion removal

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

61521 without 51 · national facility

$3,010.76

Brain lesion removal

61521-51 · Second procedure: 50%

$1,505.38

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

61521 compared with similar codes

Compare codes

61521 vs 61519 vs 61522 vs 61524: national Medicare rates

Swap in your local Medicare rate.

  • 61521
    Brain lesion removal · 45.82 wRVU
    —
  • 61519
    Meningioma removal · 42.34 wRVU
    —
  • 61522
    Brain abscess removal · 30.75 wRVU
    —
  • 61524
    Brain cyst excision · 29.14 wRVU
    —

How to choose

61519Meningioma removal
61519 is for infratentorial meningioma removal. 61521 is for a nonmeningioma tumor in the cerebellopontine angle.
61522Brain abscess removal
61522 describes removal of an infratentorial brain abscess. Use 61521 for a cerebellopontine angle tumor.
61524Brain cyst excision
61524 is for infratentorial cyst removal; 61521 is for a nonmeningioma tumor in the cerebellopontine angle.

Codes related to 61521

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

Codes related to 61521
CodeHow it relatesNational office range
Same family
61520Brain lesion removalRelated infratentorial tumor excision code; distinguish by the specified tumor site and operative approach.No office rate
61519Meningioma removalInfratentorial meningioma removal; 61521 is for a nonmeningioma cerebellopontine angle tumor.No office rate
61522Brain abscess removalInfratentorial brain abscess removal, rather than cerebellopontine angle tumor excision.No office rate
61524Brain cyst excisionInfratentorial cyst removal, rather than cerebellopontine angle tumor excision.No office rate

61521 billing questions

When is 61521 selected instead of another infratentorial tumor code?

Use 61521 for a nonmeningioma tumor in the cerebellopontine angle. The operative report should support that location and the approach; other infratentorial sites may map to different codes.

How does 61521 differ from the code for a meningioma?

61521 describes removal of a nonmeningioma tumor in the cerebellopontine angle. A meningioma removal is represented by a different code in the infratentorial family.

Are related postoperative visits included?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for 61521.

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 61521PPRRVU2026_Oct_nonQPP.csv, line 6,787 (RVU26D)

Open CMS sourceHow we calculate rates

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