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Billing code 61619: Dural repairMedicare rate & RVUs

Reports graft-based repair of a dural or cerebrospinal fluid leak involving the skull base, such as a defect causing cranial fluid drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities78 Medicare services in 2024

Medicare pays $1,565.50 for 61619 nationally in a facility.

Medicare rate · 61619

Dural repair

Swap in your local Medicare rate.

Work RVUs
21.55
Total RVUs
46.87
Global days
090

National rate · 2026

$1,565.50

Facility setting, before claim adjustments.

See every locality for 61619 → · 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 61619 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 61619 covers

This service repairs a dural defect or cerebrospinal fluid leak that involves the skull base, using a free tissue graft such as fascia, pericranium, fat, or muscle. Neurosurgeons and skull-base surgeons, including otolaryngologists working in a multidisciplinary team, may perform it in a hospital operating room. Clinical settings include repair of a skull-base leak associated with rhinorrhea or otorrhea, or closure of a skull-base dural defect encountered during surgery.

Report the code when the operative record supports a leak or defect involving the skull base and describes the graft-based repair. The 90-day global period includes 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% multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; 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 61619 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

61619 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,365.76
Alaska*Unavailable$1,823.97
ArizonaUnavailable$1,504.90
ArkansasUnavailable$1,341.58
AtlantaUnavailable$1,637.48
AustinUnavailable$1,563.65
BakersfieldUnavailable$1,512.18
Baltimore/Surr. CntysUnavailable$1,688.66
BeaumontUnavailable$1,495.17
BrazoriaUnavailable$1,499.44

61619 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
61619 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 61619 rate is calculated

Each of 61619’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 · 61619

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.55Practice expense 16.21Malpractice 9.11

46.8700 adjusted RVUs×$33.4009 conversion factor=$1,565.50

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

Payment rules and modifiers for 61619

61619 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61619

Dural repair

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)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 · 61619

Dural repair

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

61619 without 51 · national facility

$1,565.50

Dural repair

61619-51 · Second procedure: 50%

$782.75

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

61619 compared with similar codes

Compare codes

61619 vs 61618 vs 62100: national Medicare rates

Swap in your local Medicare rate.

  • 61619
    Dural repair · 21.55 wRVU
    —
  • 61618
    Dural leak repair · 18.22 wRVU
    —
  • 62100
    Brain fluid leak repair · 22.94 wRVU
    —

How to choose

61618Dural leak repair
Both describe graft-based repair of a dural or cerebrospinal fluid leak. Choose 61619 when the leak involves the skull base; 61618 is for a leak that does not.
62100Brain fluid leak repair
This code identifies graft-based repair of a leak involving the skull base. Code 62100 describes craniotomy for dural or cerebrospinal fluid leak repair; select according to the operative service documented.

Codes related to 61619

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

Codes related to 61619
CodeHow it relatesNational office range
Same family
61618Dural leak repairRelated graft-based dural leak repair when the leak does not involve the skull base.No office rate
Used instead
62100Brain fluid leak repairCraniotomy-based repair code for a dural or cerebrospinal fluid leak; distinguish the operative service performed.No office rate
Often billed with
61580Craniofacial approachAnterior cranial fossa approach code that may accompany a skull-base operation involving repair.No office rate

61619 billing questions

How do I distinguish this code from 61618?

Use 61619 for a dural or cerebrospinal fluid leak involving the skull base. Code 61618 is the related repair code for a leak that does not involve the skull base.

What documentation supports reporting 61619?

Document the skull-base location, the dural defect or leak being repaired, and the free tissue graft used. The operative report should make clear that the repair addresses the leak or defect rather than merely describing routine closure.

Can modifier 50 be used for bilateral repair?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is permitted.

How does the global period affect postoperative visits?

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

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 61619PPRRVU2026_Oct_nonQPP.csv, line 6,846 (RVU26D)

Open CMS sourceHow we calculate rates

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