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Billing code 61559: Cranial suture surgeryMedicare rate & RVUs

Reports surgical excision of fused cranial suture tissue in craniosynostosis when the documented operation removes synostotic skull rather than merely releasing or incising it.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,343.74 for 61559 nationally in a facility.

Medicare rate · 61559

Cranial suture surgery

Swap in your local Medicare rate.

Work RVUs
33.17
Total RVUs
70.17
Global days
090

National rate · 2026

$2,343.74

Facility setting, before claim adjustments.

See every locality for 61559 → · 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 61559 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 61559 covers

This code describes operative removal of fused cranial suture tissue as part of treatment for craniosynostosis. The procedure is generally performed by a neurosurgeon or craniofacial surgeon in a hospital operating room, often for an infant or child with a restricted skull growth pattern. The operative report should make clear that the surgeon excised the synostotic tissue and should identify the treated suture or skull region and the work performed.

Report the code when the documented procedure matches excision, rather than a release or incision of the suture. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services 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 61559 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

61559 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,044.77
Alaska*Unavailable$2,737.67
ArizonaUnavailable$2,252.59
ArkansasUnavailable$2,008.63
AtlantaUnavailable$2,453.35
AustinUnavailable$2,337.21
BakersfieldUnavailable$2,255.70
Baltimore/Surr. CntysUnavailable$2,528.37
BeaumontUnavailable$2,241.40
BrazoriaUnavailable$2,242.82

61559 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
61559 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 61559 rate is calculated

Each of 61559’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 · 61559

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 33.17Practice expense 23.00Malpractice 14.00

70.1700 adjusted RVUs×$33.4009 conversion factor=$2,343.74

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

Payment rules and modifiers for 61559

61559 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61559

Cranial suture surgery

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 · 61559

Cranial suture surgery

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

61559 without 51 · national facility

$2,343.74

Cranial suture surgery

61559-51 · Second procedure: 50%

$1,171.87

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

61559 compared with similar codes

Compare codes

61559 vs 61558 vs 61556 vs 61550 vs 61563: national Medicare rates

Swap in your local Medicare rate.

  • 61559
    Cranial suture surgery · 33.17 wRVU
    —
  • 61558
    Craniosynostosis surgery · 25.84 wRVU
    —
  • 61556
    Suture surgery · 23.49 wRVU
    —
  • 61550
    Craniosynostosis surgery · 15.2 wRVU
    —
  • 61563
    Skull tumor excision · 27.73 wRVU
    —

How to choose

61558Craniosynostosis surgery
Both are cranial suture excision codes. Apply the full code descriptors to the operative scope and details rather than selecting by the shared short description alone.
61556Suture surgery
This code describes incision of skull or suture tissue. Use 61559 when the documented operation excises synostotic tissue.
61550Craniosynostosis surgery
This code describes release of skull seams. The distinction is the operative work: release versus excision.
61563Skull tumor excision
This code concerns excision of a skull tumor. 61559 is for cranial suture excision in the setting of synostosis, not tumor removal.

Codes related to 61559

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

Codes related to 61559
CodeHow it relatesNational office range
Same family
61558Craniosynostosis surgeryClosely related cranial suture excision code; select according to the full descriptor and documented operative work.No office rate
Used instead
61556Suture surgeryA related skull and suture code describing incision rather than excision.No office rate
61557Craniosynostosis surgeryAnother related incision code; distinguish it by the operative technique documented.No office rate
61550Craniosynostosis surgeryAddresses release of fused skull seams rather than the excision represented here.No office rate
61552Suture releaseA related skull-seam release code; use when the documented work is release rather than excision.No office rate
61563Skull tumor excisionFor skull tumor excision, not excision of synostotic suture tissue.No office rate

61559 billing questions

How is this different from a cranial suture release or incision code?

Use this code when the operative record supports excision of synostotic tissue. Codes describing release or incision represent different operative work; the documented technique should drive selection.

Does the 90-day global include postoperative care?

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

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. 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, and other procedures are subject to the standard multiple-procedure reduction.

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 61559PPRRVU2026_Oct_nonQPP.csv, line 6,812 (RVU26D)

Open CMS sourceHow we calculate rates

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