Billing code 61580: Craniofacial approachMedicare rate & RVUs in Alaska

Reports an extradural craniofacial route to the anterior cranial fossa, typically for lesions involving the anterior skull base and adjacent sinonasal region.

CMS RVU26DEffective Oct 1, 20261 payment locality191 Medicare services in 2024

CMS doesn’t publish an office rate for 61580 in Alaska.

—Office (non-facility)
$2,731.08Hospital or facility

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

We’ll open 61580 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 61580 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 61580 covers

This service creates combined cranial and facial access to the anterior cranial fossa. The surgeon elevates the frontal lobes, performs a craniotomy and facial bone osteotomies, and works in the extradural plane. It is used for selected anterior skull-base lesions, including tumors extending between the intracranial and sinonasal spaces. Neurosurgeons and head-and-neck or craniofacial surgeons may participate, commonly in a hospital operating room. The approach described here does not include maxillectomy or orbital exenteration.

Report 61580 when the operative record supports this extradural approach and its documented extent; distinguish it from an intradural approach such as 61581. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 is restricted; co-surgeon payment requires supporting documentation, while 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.

61580 in Alaska*

61580 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*Unavailable$2,731.08

How the 61580 rate is calculated

Each of 61580’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 · 61580

RVUs × geographic indexes × conversion factor

Work33.65

33.65 RVUs× 1.000 GPCI

Practice expense25.75

25.75 RVUs× 1.000 GPCI

Malpractice7.02

7.02 RVUs× 1.000 GPCI

Adjusted RVUs

66.4200

Conversion factor

$33.4009

Medicare rate

$2,218.49

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 61580

61580 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61580

Craniofacial 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)1Not paid (statutory restriction).
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 · 61580

Craniofacial 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

61580 without 50 · national facility

$2,218.49

Craniofacial approach

61580-50 · Bilateral: 150%

$3,327.73

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

61580 compared with similar codes

Compare codes · National

4 codes, side by side

  • 61580

    Craniofacial approach33.65 wRVU

    Not priced

  • 61581

    Craniofacial approach38.15 wRVU

    Not priced

  • 61584

    Skull base approach36.76 wRVU

    Not priced

  • 61586

    Skull-base resection26.79 wRVU

    Not priced

How to choose

61581Craniofacial approach
The key distinction is the operative plane: 61580 is extradural, whereas 61581 is used for the intradural approach.
61584Skull base approach
61584 describes an orbitocranial approach. Choose 61580 for the documented craniofacial route to the anterior cranial fossa.
61586Skull-base resection
61586 concerns skull-base resection involving the nasopharynx. It is not the code for the extradural anterior craniofacial approach described by 61580.

61580 billing questions

How is 61580 distinguished from 61581?

61580 describes an extradural anterior craniofacial approach. Use the intradural code when the documented approach includes work within the dura.

Does this code describe removal of the lesion?

The code identifies the specified craniofacial approach. The operative report should separately establish the definitive work performed and support any additional reported service.

What documentation supports 61580?

Document the anterior cranial fossa exposure, extradural plane, craniotomy, facial bone osteotomies, frontal lobe elevation, and the structures or lesion reached.

How does the multiple-procedure rule affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is subject to a statutory restriction. 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 61580PPRRVU2026_Oct_nonQPP.csv, line 6,821 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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