No office rate
Both can involve subdural hematoma treatment, but 61108 uses twist-drill access and 61154 uses a burr-hole approach.
On this page
CMS RVU26D · Effective 2026-10-01
61108 Subdural drainage Medicare reimbursement rates in Colorado
Reports twist-drill cranial access to evacuate or drain a subdural hematoma, typically when a neurosurgeon treats a symptomatic subdural collection. Compare 61108 office and facility rates across CMS payment localities in Colorado.
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 61108 in Colorado?
Colorado 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
$925.32
1 of 1 localities have a supported rate.
Payment area: Colorado
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.
Neurosurgery
About 61108: Twist-drill subdural hematoma evacuation
Reports twist-drill cranial access to evacuate or drain a subdural hematoma, typically when a neurosurgeon treats a symptomatic subdural collection.
A neurosurgeon uses a twist drill to create a small opening in the skull and evacuates or drains a subdural hematoma. The service is commonly performed in a hospital operating room or other hospital setting for a patient whose subdural collection requires procedural treatment. The operative report should identify the hematoma and document the twist-drill approach and evacuation or drainage performed.
Choose this code for subdural hematoma treatment using twist-drill access, rather than a burr-hole approach or a procedure whose defining purpose is puncture or catheter placement. This major surgery has a 90-day global period, including 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 are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 61108
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.35 · 41%
- Practice expense (office) RVU11.88 · 43%
- Malpractice RVU4.58 · 16%
352
Medicare services in 2024 · #3854 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.
61108 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
61105 is for twist-drill puncture for subdural or ventricular access; 61108 is for evacuating or draining a subdural hematoma.
No office rate
61107 identifies twist-drill access with drainage-catheter insertion. Use 61108 when the service is subdural hematoma evacuation or drainage.
Compare 61108 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
Colorado →
Office / nonfacility
Unavailable
Facility
$925.32
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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 61108 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,745
- Code
- 61108
- Physician work
- 11.35
- Practice expense
- 11.88
- Malpractice
- 4.58
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.35 | × 1.012 | 11.4862 |
| Practice expense | 11.88 | × 1.064 | 12.6403 |
| Malpractice | 4.58 | × 0.781 | 3.5770 |
| Total RVUs | 27.7035 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$925.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.35 | 1.012 |
| Practice expense | 11.88 | 1.064 |
| Malpractice | 4.58 | 0.781 |
(11.35 × 1.012 + 11.88 × 1.064 + 4.58 × 0.781) × $33.4009 = $925.32
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.
61108 billing questions
How is 61108 distinguished from 61154?
61108 describes subdural hematoma treatment through a twist-drill opening. Code 61154 describes evacuation or drainage using a burr-hole approach.
When would 61105 or 61107 be a better fit?
Those codes describe twist-drill puncture services for subdural or ventricular access. Code 61107 specifically identifies insertion of a drainage catheter; 61108 is selected for evacuation or drainage of a subdural hematoma.
Can modifier 50 be used for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
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 surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not 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 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.
6,74261070,,Brain canal shunt procedure,A,,0.87,0.52,NA,0.52,,0.15,1.54,1.54,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74361105,,Tdh sdrl/ventr pnxr,A,,5.31,7.38,NA,7.38,,2.23,14.92,14.92,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74461107,,Tdh pnxr implt ventr cath,A,,4.87,1.70,NA,1.70,,2.04,8.61,8.61,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74561108,,Tdh pnxr evac&/drg sdrl hmta,A,,11.35,11.88,NA,11.88,,4.58,27.81,27.81,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,7466110F,,Counsel prov driving risks,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74761120,,Burr hole for ventr puncture,A,,9.36,9.87,NA,9.87,,3.93,23.16,23.16,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74861140,,Burr hole/treph bx brain/les,A,,16.80,14.14,NA,14.14,,7.02,37.96,37.96,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899