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Billing code 61564: Skull tumor excisionMedicare rate & RVUs

Reports operative removal of a tumor arising in the skull, such as a calvarial lesion, rather than a tumor excised from brain tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,333.05 for 61564 nationally in a facility.

Medicare rate · 61564

Skull tumor excision

Swap in your local Medicare rate.

Work RVUs
33.87
Total RVUs
69.85
Global days
090

National rate · 2026

$2,333.05

Facility setting, before claim adjustments.

See every locality for 61564 → · 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 61564 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 61564 covers

A neurosurgeon or other cranial surgeon uses a craniectomy to remove a tumor arising in the skull bone. A calvarial metastasis or a primary bone tumor involving the skull are representative clinical situations. The service is performed in an operating room, generally in a hospital or surgical facility, with the operative report establishing that the lesion originates in the skull rather than the brain.

Select the code supported by the operative details and the applicable billing code distinction from other skull-tumor excision codes. Documentation should identify the lesion’s site and origin, the surgical work performed, and the tissue removed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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 50% reduction. For a bilateral procedure reported with modifier 50, payment is at 150%. Assistant-at-surgery payment may be available; 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 61564 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

61564 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,035.24
Alaska*Unavailable$2,731.31
ArizonaUnavailable$2,241.83
ArkansasUnavailable$1,999.30
AtlantaUnavailable$2,444.04
AustinUnavailable$2,322.86
BakersfieldUnavailable$2,237.31
Baltimore/Surr. CntysUnavailable$2,517.21
BeaumontUnavailable$2,233.97
BrazoriaUnavailable$2,230.51

61564 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
61564 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 61564 rate is calculated

Each of 61564’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 · 61564

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 33.87Practice expense 21.68Malpractice 14.30

69.8500 adjusted RVUs×$33.4009 conversion factor=$2,333.05

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

Payment rules and modifiers for 61564

61564 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61564

Skull tumor excision

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 61564

Skull tumor excision

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 50 · payment effect

With and without the modifier

61564 without 50 · national facility

$2,333.05

Skull tumor excision

61564-50 · Bilateral: 150%

$3,499.58

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

61564 compared with similar codes

Compare codes

61564 vs 61563 vs 61500 vs 61545: national Medicare rates

Swap in your local Medicare rate.

  • 61564
    Skull tumor excision · 33.87 wRVU
    —
  • 61563
    Skull tumor excision · 27.73 wRVU
    —
  • 61500
    Skull lesion excision · 18.7 wRVU
    —
  • 61545
    Brain tumor surgery · 45.27 wRVU
    —

How to choose

61563Skull tumor excision
The CMS short descriptor also identifies skull-tumor excision. The short descriptor does not explain the distinction; use the full billing code descriptor and operative report.
61500Skull lesion excision
This code describes craniectomy for a benign skull lesion, cyst, or other lesion. Choose based on the applicable billing code descriptor and the documented lesion and service.
61545Brain tumor surgery
This is for excision of a brain tumor. 61564 concerns a tumor arising in the skull, as established by the operative report.

Codes related to 61564

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

Codes related to 61564
CodeHow it relatesNational office range
Same family
61563Skull tumor excisionAnother skull-tumor excision code; use the full billing code distinction and operative details to select.No office rate
Used instead
61500Skull lesion excisionCraniectomy for a benign skull lesion, cyst, or other lesion may fit instead, based on the documented service.No office rate
61545Brain tumor surgeryFor excision of a brain tumor rather than a tumor arising in skull bone.No office rate

61564 billing questions

How do I distinguish a skull tumor from a brain tumor for this code?

The operative report should show that the tumor arises in the skull bone and is excised there. A tumor excised from brain tissue points to a brain-tumor procedure instead.

How is 61564 distinguished from 61563?

CMS gives both codes the same short descriptor, so that label alone does not establish which code fits. Use the full code distinction and the operative details when selecting between them.

What documentation supports reporting 61564?

Document the tumor’s anatomic site and origin in the skull, the craniectomy and excision performed, and the tissue removed. The record should make clear that the target was skull bone, not brain tissue.

How does the 90-day global period affect postoperative billing?

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

What payment rules apply when other procedures or surgeons are involved?

In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment needs supporting documentation, while 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 61564PPRRVU2026_Oct_nonQPP.csv, line 6,814 (RVU26D)

Open CMS sourceHow we calculate rates

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