Billing code 61313: Hematoma evacuationMedicare rate & RVUs in Iowa

Reports craniotomy or craniectomy to evacuate a hematoma within the brain parenchyma above the tentorium, rather than an extra-axial collection.

CMS RVU26DEffective Oct 1, 20261 payment locality1.2K Medicare services in 2024

CMS doesn’t publish an office rate for 61313 in Iowa.

—Office (non-facility)
$1,660.85Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 61313 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Iowa
  2. What 61313 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 61313 covers

A neurosurgeon performs a craniotomy or craniectomy to reach and evacuate a hematoma located within the supratentorial brain parenchyma. This code applies to an intracerebral collection; the operative report should distinguish it from blood outside the brain tissue, such as an extradural or subdural hematoma. These procedures are typically performed in an operating room for a patient requiring surgical management of an intracerebral hemorrhage.

Report the service when the documented site is supratentorial and the hematoma is intracerebral. The operative report should support both the location and the evacuation 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 50% reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

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.

61313 in Iowa

61313 office and facility rates by payment locality
Payment localityOfficeFacility
IowaUnavailable$1,660.85

How the 61313 rate is calculated

Each of 61313’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 · 61313

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 27.39Practice expense 19.42Malpractice 11.50

58.3100 adjusted RVUs×$33.4009 conversion factor=$1,947.61

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 61313

61313 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61313

Hematoma evacuation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 61313

Hematoma evacuation

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

61313 without 51 · national facility

$1,947.61

Hematoma evacuation

61313-51 · Second procedure: 50%

$973.81

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

61313 compared with similar codes

Compare codes

61313 vs 61312 vs 61314 vs 61315 vs 61320: national Medicare rates

Swap in your local Medicare rate.

  • 61313
    Hematoma evacuation · 27.39 wRVU
    —
  • 61312
    Hematoma evacuation · 29.42 wRVU
    —
  • 61314
    Hematoma evacuation · 25.25 wRVU
    —
  • 61315
    Hematoma evacuation · 28.91 wRVU
    —
  • 61320
    Abscess drainage · 26.73 wRVU
    —

How to choose

61312Hematoma evacuation
Use 61313 for an intracerebral hematoma above the tentorium; use 61312 for a supratentorial extradural or subdural collection.
61314Hematoma evacuation
Both codes address extradural or subdural hematomas, but 61314 is for an infratentorial collection rather than a supratentorial intracerebral one.
61315Hematoma evacuation
61315 addresses an intracerebellar hematoma below the tentorium; 61313 is for an intracerebral hematoma above it.
61320Abscess drainage
61320 is for drainage of a supratentorial intracranial abscess, not evacuation of an intracerebral hematoma.

61313 billing questions

How does this differ from 61312?

61313 is for a hematoma within supratentorial brain tissue. Code 61312 is for a supratentorial extradural or subdural hematoma.

Does the code include the craniotomy or craniectomy?

Yes. The reported service includes the cranial opening and evacuation of the intracerebral hematoma; do not separately report the access as another craniotomy or craniectomy service.

What documentation supports choosing this code?

The operative report should identify the hematoma as intracerebral, establish its supratentorial location, and describe its surgical evacuation.

Can modifier 50 be used?

No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor and anatomy.

How are assistant and co-surgeon services handled?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery 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 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
RVUs for 61313PPRRVU2026_Oct_nonQPP.csv, line 6,760 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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