Billing code 61592: Skull base approachMedicare rate & RVUs

Medicare pays $3,033.47 for 61592 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 61592 covers

This code describes a surgical exposure to the middle cranial fossa through an orbitocranial zygomatic route, with operative work that may include elevation of the temporal lobe. Neurosurgeons and skull-base surgeons use this approach when the planned operation requires access through this corridor; it is typically performed in a hospital operating room. The operative report should identify the route and describe the exposure performed, rather than relying only on the underlying diagnosis or lesion location.

Select 61592 based on the approach documented, distinguishing it from anterior-fossa orbitocranial and other middle-fossa corridors. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 61592 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

61592 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 61592 rate is calculated

Each of 61592’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.

Payment rules and modifiers for 61592

61592 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

61592 compared with similar codes

How to choose

61584Skull base approach

Both are orbitocranial approach codes, but 61592 identifies the zygomatic route to the middle cranial fossa. Use the operative report to distinguish the approach.

61585Orbitocranial approach

This is another orbitocranial skull-base approach code. The documented route and operative exposure, rather than the diagnosis alone, guide code selection.

61590Skull base approach

61590 describes an infratemporal approach to the middle cranial fossa. 61592 is the orbitocranial zygomatic route.

61595Skull base approach

61595 describes a transtemporal skull-base route, not the orbitocranial zygomatic exposure represented by 61592.

Codes related to 61592

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

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

Open CMS sourceHow we calculate rates