FeeBase
Log inGet started
Menu

CPT 61584: Skull base approachMedicare rate & RVUs

Reports an extradural orbitocranial route to the anterior cranial fossa using orbital osteotomy, typically to expose lesions at the anterior skull base.

CMS RVU26DEffective Oct 1, 2026109 payment localities283 Medicare services in 2024

Medicare pays $2,831.39 for 61584 nationally in a facility.

Medicare rate · 61584

Skull base approach

Swap in your local Medicare rate.

Work RVUs
36.76
Total RVUs
84.77
Global days
090

National rate · 2026

$2,831.39

Facility setting, before claim adjustments.

See every locality for 61584 →

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 61584 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 61584 covers

This code describes an extradural surgical corridor to the anterior cranial fossa created through an orbitocranial approach with orbital osteotomy and elevation of the frontal lobe. Neurosurgeons commonly perform the approach for operations involving anterior skull base lesions, sometimes with an otolaryngologist or craniofacial surgeon participating. It is generally performed in a hospital operating room rather than an office setting.

Select this code when the operative report supports the anterior fossa target, extradural route, and orbital osteotomy; an intradural route is a different service. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 61584 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

61584 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,482.95
Alaska*Unavailable$3,303.35
ArizonaUnavailable$2,727.56
ArkansasUnavailable$2,440.52
AtlantaUnavailable$2,949.34
AustinUnavailable$2,844.47
BakersfieldUnavailable$2,775.41
Baltimore/Surr. CntysUnavailable$3,046.65
BeaumontUnavailable$2,696.17
BrazoriaUnavailable$2,725.72

61584 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
61584 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 61584 rate is calculated

Each of 61584’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 · 61584

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 36.76Practice expense 33.67Malpractice 14.34

84.7700 adjusted RVUs×$33.4009 conversion factor=$2,831.39

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

Payment rules and modifiers for 61584

61584 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61584

Skull base approach

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)2Permitted.
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 · 61584

Skull base approach

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

61584 without 50 · national facility

$2,831.39

Skull base approach

61584-50 · Bilateral: 150%

$4,247.09

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

61584 compared with similar codes

Compare codes

61584 vs 61585 vs 61580 vs 61592: national Medicare rates

Swap in your local Medicare rate.

  • 61584
    Skull base approach · 36.76 wRVU
    —
  • 61585
    Orbitocranial approach · 41.51 wRVU
    —
  • 61580
    Craniofacial approach · 33.65 wRVU
    —
  • 61592
    Skull base approach · 42 wRVU
    —

How to choose

61585Orbitocranial approach
This code describes the extradural orbitocranial route to the anterior cranial fossa. 61585 is the intradural counterpart.
61580Craniofacial approach
61580 describes a craniofacial route to the anterior cranial fossa. 61584 specifies an orbitocranial route with orbital osteotomy.
61592Skull base approach
Both involve an orbitocranial approach, but 61592 is directed to a different cranial fossa target. Base selection on the operative corridor and target.

Codes related to 61584

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

Codes related to 61584
CodeHow it relatesNational office range
Same family
61585Orbitocranial approachOrbitocranial approach to the anterior cranial fossa with an intradural route.No office rate
61580Craniofacial approachCraniofacial approach to the anterior cranial fossa, rather than an orbitocranial route.No office rate
61582Craniofacial approachIntradural craniofacial approach to the anterior cranial fossa.No office rate
61592Skull base approachOrbitocranial approach directed to a different cranial fossa target.No office rate

61584 billing questions

How does 61584 differ from 61585?

Both describe an orbitocranial approach to the anterior cranial fossa with orbital osteotomy. Choose 61584 for an extradural route and 61585 for an intradural route.

What operative documentation supports 61584?

The operative report should identify the anterior cranial fossa target, the extradural corridor, the orbital osteotomy, and the frontal-lobe elevation performed as part of the approach.

Does the approach code include the lesion resection?

The code describes the surgical approach, not the identity of the lesion or the full extent of its treatment. Review the operative work and applicable CPT instructions when determining whether another procedure code is reportable.

When is modifier 50 appropriate?

Use modifier 50 when the documented service is performed bilaterally. CMS pays a bilateral procedure reported with modifier 50 at 150%.

What postoperative care is included?

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 available. Co-surgeon payment requires supporting documentation; team surgery is 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 61584PPRRVU2026_Oct_nonQPP.csv, line 6,825 (RVU26D)

Open CMS sourceHow we calculate rates

Fee sheets

Put 61584 and the rest of your codes on one sheet

Current Medicare rates for every code you bill at your locality, with what changed since last quarter.

Get a fee sheetOr price your code list free →