No office rate
Both are cranial suture excision codes. Apply the full code descriptors to the operative scope and details rather than selecting by the shared short description alone.
On this page
CMS RVU26D · Effective 2026-10-01
61559 Cranial suture surgery Medicare reimbursement rates in Florida
Reports surgical excision of fused cranial suture tissue in craniosynostosis when the documented operation removes synostotic skull rather than merely releasing or incising it. Compare 61559 office and facility rates across CMS payment localities in Florida.
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 61559 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2545.15–$3090.22
3 of 3 localities have a supported rate.
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.
Where 61559 pays more and less in Florida
Neurosurgery
About 61559: Cranial suture excision for synostosis
Reports surgical excision of fused cranial suture tissue in craniosynostosis when the documented operation removes synostotic skull rather than merely releasing or incising it.
This code describes operative removal of fused cranial suture tissue as part of treatment for craniosynostosis. The procedure is generally performed by a neurosurgeon or craniofacial surgeon in a hospital operating room, often for an infant or child with a restricted skull growth pattern. The operative report should make clear that the surgeon excised the synostotic tissue and should identify the treated suture or skull region and the work performed.
Report the code when the documented procedure matches excision, rather than a release or incision of the suture. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 61559
- 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 RVU33.17 · 47%
- Practice expense (office) RVU23.00 · 33%
- Malpractice RVU14.00 · 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.
61559 compared with similar codes
Office rates for Florida, from the same CMS release.
No office rate
This code describes incision of skull or suture tissue. Use 61559 when the documented operation excises synostotic tissue.
No office rate
This code describes release of skull seams. The distinction is the operative work: release versus excision.
No office rate
This code concerns excision of a skull tumor. 61559 is for cranial suture excision in the setting of synostosis, not tumor removal.
Compare 61559 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
Unavailable
Facility
$2731.56
Miami →
Office / nonfacility
Unavailable
Facility
$3090.22
Rest Of Florida →
Office / nonfacility
Unavailable
Facility
$2545.15
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
61559 billing questions
How is this different from a cranial suture release or incision code?
Use this code when the operative record supports excision of synostotic tissue. Codes describing release or incision represent different operative work; the documented technique should drive selection.
Does the 90-day global include postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
6,80961556,,Incise skull/sutures,A,,23.49,16.82,NA,16.82,,9.92,50.23,50.23,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81061557,,Incise skull/sutures,A,,22.73,17.76,NA,17.76,,9.60,50.09,50.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81161558,,Excision of skull/sutures,A,,25.84,18.61,NA,18.61,,10.92,55.37,55.37,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81261559,,Excision of skull/sutures,A,,33.17,23.00,NA,23.00,,14.00,70.17,70.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81361563,,Excision of skull tumor,A,,27.73,18.31,NA,18.31,,11.72,57.76,57.76,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81461564,,Excision of skull tumor,A,,33.87,21.68,NA,21.68,,14.30,69.85,69.85,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81561566,,Removal of brain tissue,A,,31.64,20.04,NA,20.04,,13.37,65.05,65.05,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00