Billing code 61581: Craniofacial approachMedicare rate & RVUs in Florida
Reports a craniofacial surgical route to the anterior cranial fossa when a lesion requires access through the cranial and facial regions.
CMS doesn’t publish an office rate for 61581 in Florida.
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 61581 covers
This code describes a craniofacial route for reaching the anterior cranial fossa, where a lesion may involve the skull base near the nasal cavity or paranasal sinuses. The operation combines cranial and facial exposure; a neurosurgeon may work with an otolaryngologist or another surgeon experienced in skull base surgery. It is generally performed in a hospital operating room for complex skull base disease, rather than as an office procedure.
Select the code from the operative report’s documented approach and the specific work performed, not simply the diagnosis or lesion location. The record should identify the cranial and facial exposure and the target area. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 results in payment at 150% for a bilateral procedure. Co-surgeons and team surgery are permitted; assistant-at-surgery services are subject to a statutory payment restriction.
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.
Where 61581 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $2,521.79 |
| Miami | Unavailable | $2,681.11 |
| Rest Of Florida | Unavailable | $2,413.78 |
How the 61581 rate is calculated
Each of 61581’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 · 61581
RVUs × geographic indexes × conversion factor
Work38.15
38.15 RVUs× 1.000 GPCI
Practice expense26.93
26.93 RVUs× 1.000 GPCI
Malpractice5.57
5.57 RVUs× 1.000 GPCI
Adjusted RVUs
70.6500
Conversion factor
$33.4009
Medicare rate
$2,359.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61581
61581 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61581
Craniofacial approach
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 2 | 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 · 61581
Craniofacial approach
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 50 · payment effect
With and without the modifier
61581 without 50 · national facility
$2,359.77
Craniofacial approach
61581-50 · Bilateral: 150%
$3,539.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
61581 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61584Skull base approach
- Use 61584 when the documented route is orbitocranial. This code is for the craniofacial approach to the anterior cranial fossa.
- 61590Skull base approach
- 61590 describes an infratemporal approach. Choose this code when the operative report documents a craniofacial route to the anterior cranial fossa.
- 61580Craniofacial approach
- 61580 is a neighboring craniofacial approach code. Distinguish it from 61581 by the specific approach variant documented in the operative report.
61581 billing questions
How is this different from an orbitocranial approach?
This code identifies a craniofacial route to the anterior cranial fossa. Codes 61584, 61585, and 61592 identify orbitocranial approaches; select according to the approach documented in the operative report.
What documentation supports reporting this approach?
The operative report should describe the cranial and facial exposure and identify the anterior cranial fossa target. The diagnosis alone does not establish which approach code applies.
Can co-surgeons report this service?
CMS permits co-surgeons for this code. The record should support each surgeon’s distinct role in the operation.
Can an assistant-at-surgery be paid for this code?
CMS lists a statutory restriction on assistant-at-surgery payment for this service.
How are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%. Related postoperative care is included in the 90-day global period.
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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