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CMS RVU26D · Effective 2026-10-01

61543 Seizure focus excision Medicare reimbursement rates in Delaware

Reports craniotomy to remove a brain area identified as an epileptogenic focus when intraoperative electrocorticography is not performed. Compare 61543 office and facility rates across CMS payment localities in Delaware.

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 61543 in Delaware?

Delaware 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

$2063.63

1 of 1 localities have a supported rate.

Payment area: Delaware

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.

Find 61543 in your payment locality →

Neurosurgery

About 61543: Epileptogenic focus excision without electrocorticography

Reports craniotomy to remove a brain area identified as an epileptogenic focus when intraoperative electrocorticography is not performed.

A neurosurgeon uses a craniotomy to remove brain tissue identified as the source of seizures. This operation is used in epilepsy surgery when the treatment plan calls for excision of a discrete epileptogenic focus and electrocorticography is not performed during the operation. The operative report should establish the seizure-related target and describe the tissue removed; a general brain lesion excision or a planned lobectomy may fit a different code.

Report one unit for the qualifying operation. Documentation should distinguish focus excision from lobectomy and state whether intraoperative electrocorticography was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple-procedure reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 61543

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 not permitted.

Where the value comes from

  • Work RVU30.53 · 48%
  • Practice expense (office) RVU19.75 · 31%
  • Malpractice RVU12.89 · 20%

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.

61543 compared with similar codes

Office rates for Delaware, from the same CMS release.

61544

Seizure focus excision

With intraoperative electrocorticography

No office rate

The key distinction is intraoperative electrocorticography: 61543 is for focus excision without it, while 61544 is for focus excision with it.

61534

Epilepsy surgery

With intraoperative electrocorticography

No office rate

61534 describes temporal lobectomy without intraoperative electrocorticography. Use 61543 for excision of an epileptogenic focus when the operation is not documented as a temporal lobectomy.

61545

Brain tumor surgery

Operative tumor removal

No office rate

61545 is for excision of a brain tumor. Choose 61543 when the operative target is an epileptogenic focus rather than a tumor.

Compare 61543 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

Office and facility base rates · shared scale starting at $0

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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 61543 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

6,802

Code
61543
Physician work
30.53
Practice expense
19.75
Malpractice
12.89

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Facility calculation for 61543 in Delaware
ComponentRVULocality factorAdjusted
Physician work30.53× 1.00530.6826
Practice expense19.75× 0.98819.5130
Malpractice12.89× 0.89911.5881
Total RVUs61.7838
Conversion factor× 33.4009

Facility rate, Delaware$2063.63

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work30.531.005
Practice expense19.750.988
Malpractice12.890.899

(30.53 × 1.005 + 19.75 × 0.988 + 12.89 × 0.899) × $33.4009 = $2063.63

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.

61543 billing questions

How does this code differ from 61544?

Both describe excision of an epileptogenic focus. Use 61543 when intraoperative electrocorticography is not performed; 61544 represents the corresponding procedure with electrocorticography.

Is this the right code for a temporal lobectomy?

Not when the operation is documented as a temporal lobectomy. Select the lobectomy code that matches the procedure and whether intraoperative electrocorticography was performed.

What documentation supports reporting 61543?

The operative report should identify the epileptogenic focus, describe the brain tissue excised, and support that intraoperative electrocorticography was not performed.

Can an assistant or co-surgeon be reported?

CMS allows payment for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the 90-day global period affect postoperative billing?

The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical global package.

What happens when another procedure is performed in the same session?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures.

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.

RVUs for 61543PPRRVU2026_Oct_nonQPP.csv, line 6,802 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet