Billing code 61323: Cranial decompressionMedicare rate & RVUs in Iowa
Reports cranial decompression that includes removal of a portion of brain tissue, typically during surgery for severe intracranial swelling or pressure.
CMS doesn’t publish an office rate for 61323 in Iowa.
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 61323 covers
A neurosurgeon performs a craniectomy or craniotomy to relieve pressure within the skull and removes a portion of brain tissue as part of that decompressive operation. The procedure is generally performed in an operating room for a patient with severe intracranial swelling or pressure requiring surgical decompression. The documented operative work must include the lobectomy component, not decompression alone.
Report this code when the operation includes both cranial decompression and lobectomy; code 61322 describes the related decompression service without lobectomy. The operative report should identify the decompressive approach, the tissue removed, and the reason for the operation. 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. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.
61323 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $1,950.81 |
How the 61323 rate is calculated
Each of 61323’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 · 61323
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 34.18Practice expense 20.22Malpractice 14.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61323
61323 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61323
Cranial decompression
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not 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 · 61323
Cranial decompression
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 51 · payment effect
With and without the modifier
61323 without 51 · national facility
$2,298.65
Cranial decompression
61323-51 · Second procedure: 50%
$1,149.33
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%).
61323 compared with similar codes
Compare codes
61323 vs 61322 vs 61312 vs 61313: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61322Cranial decompression
- Both describe cranial decompression, but 61323 includes lobectomy as part of the operation; 61322 describes decompression without lobectomy.
- 61312Hematoma evacuation
- 61312 describes evacuation of a supratentorial extradural or subdural hematoma. Choose based on the documented operative target rather than treating it as decompression with lobectomy.
- 61313Hematoma evacuation
- 61313 describes evacuation of an intracerebral hematoma. This code is for decompression that includes lobectomy, rather than hematoma evacuation as the defining service.
61323 billing questions
How does this differ from 61322?
Use 61323 when lobectomy is part of the decompressive operation. Use 61322 for the related decompression service without lobectomy.
Should the lobectomy be reported separately?
The lobectomy is included in this decompressive service. The operative report should document the tissue removal as part of the decompression.
Can modifier 50 be used?
No. The code's descriptor and anatomy make modifier 50 inappropriate.
Can an assistant surgeon be paid?
Assistant-at-surgery payment may be made for this procedure. Co-surgeon payment requires supporting documentation.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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