CPT code 61305: Cranial exploration2026 Medicare rate & RVUs in Delaware
Reports an exploratory cranial opening to inspect the infratentorial compartment, including the posterior fossa around the cerebellum and brainstem.
CMS doesn’t publish an office rate for 61305 in Delaware.
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 9 sections
What 61305 covers
61305 represents an exploratory cranial opening directed to the infratentorial compartment—the posterior fossa beneath the tentorium, including access around the cerebellum and brainstem. A neurosurgeon performs the craniotomy or craniectomy in an operating room when the operative objective is exploration rather than a defined evacuation or drainage procedure. Select the code by the compartment entered, not by the skin incision or the patient’s presenting symptom.
The operative report should identify the infratentorial target and document that exploration was the work performed. If the surgeon treats a specified hematoma or abscess, select the procedure code describing that objective instead. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code’s anatomy and descriptor.
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.
61305 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,917.19 |
How the 61305 rate is calculated
Each of 61305’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 · 61305
RVUs × geographic indexes × conversion factor
Work27.92
27.92 RVUs× 1.000 GPCI
Practice expense18.95
18.95 RVUs× 1.000 GPCI
Malpractice11.81
11.81 RVUs× 1.000 GPCI
Adjusted RVUs
58.6800
Conversion factor
$33.4009
Medicare rate
$1,959.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61305
61305 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61305
Cranial exploration
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 61305
Cranial exploration
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
61305 without 51 · national facility
$1,959.96
Cranial exploration
61305-51 · Second procedure: 50%
$979.98
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%).
61305 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61304Exploratory craniotomy
- Choose 61305 for exploration below the tentorium in the posterior fossa; choose 61304 for exploration above the tentorium.
- 61314Hematoma evacuation
- 61305 describes infratentorial exploration. Use 61314 when the operation is specifically evacuation of an infratentorial extradural or subdural hematoma.
- 61315Hematoma evacuation
- 61305 describes exploration; 61315 applies when the surgeon evacuates an intracerebellar hematoma.
61305 billing questions
How does 61305 differ from 61304?
61305 is for exploration of the infratentorial compartment below the tentorium. 61304 describes exploration of the supratentorial compartment above it.
When would 61314 or 61315 be more appropriate?
Use the code for the operative objective when the surgeon evacuates a defined hematoma: 61314 for infratentorial extradural or subdural hematoma, and 61315 for intracerebellar hematoma. 61305 describes exploration.
What should the operative report establish?
Document the infratentorial site entered and that exploration was the work performed. The report should distinguish exploration from a specific procedure such as hematoma evacuation or abscess drainage.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s descriptor and anatomy.
How are assistants and co-surgeons handled?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while team surgery is 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 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
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