No office rate
61595 represents a transtemporal approach to the posterior cranial fossa. Use 61596 when the operative route is transcochlear and includes its distinct exposure work.
On this page
CMS RVU26D · Effective 2026-10-01
61596 Skull base approach Medicare reimbursement rates in Delaware
Reports transcochlear surgical access to the posterior cranial fossa, including the extensive ear and temporal-bone work needed for skull base lesion surgery. Compare 61596 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 61596 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
$2069.67
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.
Skull base surgery
About 61596: Transcochlear posterior fossa approach
Reports transcochlear surgical access to the posterior cranial fossa, including the extensive ear and temporal-bone work needed for skull base lesion surgery.
This approach reaches the posterior cranial fossa through the temporal bone and cochlear region. The exposure includes mastoid work, removal of petrous bone, and posterior transposition of the facial nerve. It is used by skull base teams, typically involving an otologist or neurotologist and a neurosurgeon, to access lesions near the clivus, petrous apex, or ventral brainstem. The route is selected when the required exposure calls for this specific transcochlear corridor rather than a transtemporal or transpetrosal route.
Report the approach based on the operative route and documented work, not just the lesion’s location. The approach includes its described exposure steps; document the facial nerve transposition and bony work performed. Report the definitive lesion procedure separately when supported by the applicable CPT instructions. CMS classifies this as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. For a bilateral procedure reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is permitted.
CMS billing rules for 61596
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU38.44 · 61%
- Practice expense (office) RVU18.52 · 30%
- Malpractice RVU5.60 · 9%
80
Medicare services in 2024 · #5053 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.
61596 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
61597 uses a transcondylar route, typically involving access around the occipital condyle. It is not the transcochlear temporal-bone approach described by 61596.
No office rate
61598 represents a transpetrosal route. Choose between it and 61596 based on the approach actually performed and documented, not merely the target lesion.
No office rate
61616 describes resection of an intradural posterior cranial fossa lesion; 61596 describes the transcochlear approach. The codes represent different parts of the operative service.
Compare 61596 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
Delaware →
Office / nonfacility
Unavailable
Facility
$2069.67
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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 61596 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,832
- Code
- 61596
- Physician work
- 38.44
- Practice expense
- 18.52
- Malpractice
- 5.60
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 38.44 | × 1.005 | 38.6322 |
| Practice expense | 18.52 | × 0.988 | 18.2978 |
| Malpractice | 5.60 | × 0.899 | 5.0344 |
| Total RVUs | 61.9644 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$2069.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 38.44 | 1.005 |
| Practice expense | 18.52 | 0.988 |
| Malpractice | 5.6 | 0.899 |
(38.44 × 1.005 + 18.52 × 0.988 + 5.6 × 0.899) × $33.4009 = $2069.67
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.
61596 billing questions
How is this approach different from 61595?
61596 describes a transcochlear route with petrous bone removal and posterior facial nerve transposition. 61595 describes a transtemporal route; select the code matching the operative corridor and documented approach.
Does 61596 include the lesion removal?
The code describes the transcochlear approach and its exposure work. Report the definitive lesion procedure separately when the applicable CPT instructions support separate reporting.
Which parts of the exposure are included?
The approach includes the associated mastoid work, petrous apicectomy, and posterior transposition of the facial nerve described for this route. Do not separately report those steps as though they were independent procedures.
What documentation supports 61596?
The operative report should identify the transcochlear route and describe the mastoid and petrous bone work and facial nerve transposition. The documented approach, not simply the diagnosis or lesion site, supports code selection.
Can modifier 50 be used?
CMS lists this as a bilateral procedure; when the procedure is bilateral and reported with modifier 50, payment is at 150%. The operative documentation must support bilateral performance.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment. Co-surgeons are paid only when supporting documentation is provided; team surgery is also 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.
6,82961591,,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
6,83161595,,Transtemporal approach/skull,A,,32.90,24.06,NA,24.06,,8.49,65.45,65.45,0,090,0.11,0.76,0.13,2,1,1,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83261596,,Transcochlear approach/skull,A,,38.44,18.52,NA,18.52,,5.60,62.56,62.56,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83361597,,Transcondylar approach/skull,A,,39.80,32.18,NA,32.18,,16.81,88.79,88.79,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83461598,,Transpetrosal approach/skull,A,,35.62,34.60,NA,34.60,,15.04,85.26,85.26,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83561600,,Resect/excise cranial lesion,A,,29.26,21.58,NA,21.58,,6.49,57.33,57.33,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503