No office rate
This code concerns resection involving the nasopharynx and skull base. Code 61575 describes a transoral route to the skull base, brainstem, or upper spinal cord.
On this page
CMS RVU26D · Effective 2026-10-01
61586 Skull-base resection Medicare reimbursement rates in Alabama
Reports surgical removal of a lesion involving the nasopharynx and skull base, typically performed by a multidisciplinary skull-base team in a hospital operating room. Compare 61586 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 61586 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2304.44
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Skull-base surgery
About 61586: Nasopharyngeal skull-base tumor resection
Reports surgical removal of a lesion involving the nasopharynx and skull base, typically performed by a multidisciplinary skull-base team in a hospital operating room.
This code describes a major operation to remove a lesion involving both the nasopharynx and skull base. The surgeon’s work is directed at resection, rather than biopsy alone. Cases may involve an otolaryngologist or head-and-neck surgeon working with a neurosurgeon, particularly when the lesion extends toward the cranial base. A nasopharyngeal tumor with skull-base extension, such as a juvenile nasopharyngeal angiofibroma, is a representative clinical situation. These operations are generally performed in a hospital operating room.
Select the code when the operative report supports removal of the lesion at the nasopharynx-skull-base site; document the extent, structures addressed, and resection performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is permitted.
CMS billing rules for 61586
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery permitted.
Where the value comes from
- Work RVU26.79 · 34%
- Practice expense (office) RVU40.91 · 52%
- Malpractice RVU11.32 · 14%
27
Medicare services in 2024 · #5743 by national volume
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.
61586 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Code 61580 describes craniofacial access to the anterior cranial fossa. Choose based on the operation and route documented, rather than treating the codes as interchangeable.
No office rate
Code 61590 describes an infratemporal approach. This code identifies resection involving the nasopharynx and skull base, so the operative target and route help distinguish them.
Compare 61586 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$2304.44
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 61586 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,827
- Code
- 61586
- Physician work
- 26.79
- Practice expense
- 40.91
- Malpractice
- 11.32
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.79 | × 1.000 | 26.7900 |
| Practice expense | 40.91 | × 0.875 | 35.7963 |
| Malpractice | 11.32 | × 0.566 | 6.4071 |
| Total RVUs | 68.9934 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$2304.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.79 | 1 |
| Practice expense | 40.91 | 0.875 |
| Malpractice | 11.32 | 0.566 |
(26.79 × 1 + 40.91 × 0.875 + 11.32 × 0.566) × $33.4009 = $2304.44
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
61586 billing questions
How is this distinguished from a skull-base approach code?
This code represents resection of a lesion involving the nasopharynx and skull base. Approach codes describe a particular route used to reach the skull base; use the operative details to identify the service performed.
Does the 90-day global period include postoperative visits?
Yes. Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this service. Co-surgeon payment requires supporting documentation.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,82461583,,Craniofacial approach skull,A,,37.54,34.62,NA,34.62,,15.37,87.53,87.53,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82561584,,Orbitocranial approach/skull,A,,36.76,33.67,NA,33.67,,14.34,84.77,84.77,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82661585,,Orbitocranial approach/skull,A,,41.51,38.43,NA,38.43,,17.52,97.46,97.46,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82761586,,Resect nasopharynx skull,A,,26.79,40.91,NA,40.91,,11.32,79.02,79.02,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82861590,,Infratemporal approach/skull,A,,45.86,24.78,NA,24.78,,9.17,79.81,79.81,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82961591,,Infratemporal approach/skull,A,,45.84,26.12,NA,26.12,,11.25,83.21,83.21,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83061592,,Orbitocranial approach/skull,A,,42.00,32.70,NA,32.70,,16.12,90.82,90.82,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515