No office rate
61458 is for suboccipital exploration or decompression of cranial nerves. Choose 61460 when the operative report documents nerve section.
On this page
CMS RVU26D · Effective 2026-10-01
61460 Cranial nerve surgery Medicare reimbursement rates in Hawaii
Reports a suboccipital craniectomy performed to section one or more cranial nerves, rather than to explore or decompress them. Compare 61460 office and facility rates across CMS payment localities in Hawaii.
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 61460 in Hawaii?
Hawaii 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
$1961.61
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Neurosurgery
About 61460: Suboccipital cranial nerve section
Reports a suboccipital craniectomy performed to section one or more cranial nerves, rather than to explore or decompress them.
A neurosurgeon uses a suboccipital approach to reach and intentionally divide one or more cranial nerves inside the skull. The operation is distinct from opening the area only to inspect or decompress a nerve. A posterior fossa nerve section for selected cases of severe, otherwise difficult-to-control cranial neuralgia is a representative clinical context. This service is generally performed in a hospital operating room.
Choose the code from the operative objective and documented work: cranial nerve section through a suboccipital craniectomy. The operative report should identify the nerve or nerves treated and document that sectioning was performed, rather than decompression alone. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. An assistant at surgery may be paid, and co-surgeons are permitted; team-surgery payment is not permitted. Modifier 50 is inappropriate for this descriptor.
CMS billing rules for 61460
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU29.48 · 48%
- Practice expense (office) RVU19.38 · 32%
- Malpractice RVU12.46 · 20%
16
Medicare services in 2024 · #6045 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.
61460 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
61450 is directed to decompression of the medulla and spinal cord. It does not describe sectioning cranial nerves.
Compare 61460 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1961.61
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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 61460 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
6,775
- Code
- 61460
- Physician work
- 29.48
- Practice expense
- 19.38
- Malpractice
- 12.46
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 29.48 | × 1.000 | 29.4800 |
| Practice expense | 19.38 | × 1.137 | 22.0351 |
| Malpractice | 12.46 | × 0.579 | 7.2143 |
| Total RVUs | 58.7294 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1961.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 29.48 | 1 |
| Practice expense | 19.38 | 1.137 |
| Malpractice | 12.46 | 0.579 |
(29.48 × 1 + 19.38 × 1.137 + 12.46 × 0.579) × $33.4009 = $1961.61
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.
61460 billing questions
How is this code distinguished from 61458?
Use 61460 when the suboccipital operation sections one or more cranial nerves. Code 61458 describes exploration or decompression of cranial nerves, not their section.
When is 61450 a better fit?
61450 concerns suboccipital decompression of the medulla and spinal cord. Select 61460 when the documented operative objective is cranial nerve section.
What documentation supports reporting 61460?
The operative report should establish the suboccipital approach and state that one or more cranial nerves were intentionally sectioned. A diagnosis or mention of neuralgia alone does not establish that operative work.
Can modifier 50 be reported?
No. The code’s descriptor and anatomy make modifier 50 inappropriate.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons for this code. Team-surgery payment 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 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.
6,77261345,,Oth cranial dcmprn pst fossa,A,,28.50,19.03,NA,19.03,,12.04,59.57,59.57,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,77361450,,Crnec stpl sctj cmprn/dcmprn,A,,27.00,17.45,NA,17.45,,11.41,55.86,55.86,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,77461458,,Crnec sopl xpl/dcmpr crl nrv,A,,28.12,18.84,NA,18.84,,11.83,58.79,58.79,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,77561460,,Crnec sopl sctj 1+crnl nrv,A,,29.48,19.38,NA,19.38,,12.46,61.32,61.32,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,77661500,,Crnec exc tum/bone les skull,A,,18.70,11.62,NA,11.62,,5.57,35.89,35.89,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,77761501,,Craniectomy f/osteomyelitis,A,,15.94,10.99,NA,10.99,,4.69,31.62,31.62,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,7786150F,,Pt notrcvng1st antitnf txmnt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014