CPT code 61343: Posterior fossa decompression2026 Medicare rate & RVUs in Kentucky
Reports suboccipital and upper cervical bone removal to decompress the medulla and spinal cord, commonly for crowding at the foramen magnum.
CMS doesn’t publish an office rate for 61343 in Kentucky.
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 61343 covers
This operation removes bone at the base of the skull and from the upper cervical spine to relieve pressure on the lower brainstem and spinal cord. Neurosurgeons commonly perform it for symptomatic Chiari malformation with crowding at the foramen magnum. It is generally an operating-room procedure in a hospital or other surgical facility.
Select this code when the operative report supports posterior fossa decompression that includes cervical laminectomy for the cervicomedullary region. The report should identify the decompression performed and the relevant anatomy; the cervical bone removal is part of this operative service, not a separate laminectomy for the same decompression. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery services may be paid; 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.
61343 in Kentucky
| Payment locality | Office | Facility |
|---|---|---|
| Kentucky | Unavailable | $2,004.04 |
How the 61343 rate is calculated
Each of 61343’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 · 61343
RVUs × geographic indexes × conversion factor
Work31.06
31.06 RVUs× 1.000 GPCI
Practice expense19.43
19.43 RVUs× 1.000 GPCI
Malpractice12.75
12.75 RVUs× 1.000 GPCI
Adjusted RVUs
63.2400
Conversion factor
$33.4009
Medicare rate
$2,112.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61343
61343 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61343
Posterior fossa 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 · 61343
Posterior fossa 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
61343 without 51 · national facility
$2,112.27
Posterior fossa decompression
61343-51 · Second procedure: 50%
$1,056.14
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%).
61343 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61345Cranial decompression
- 61343 describes suboccipital decompression that includes cervical laminectomy for the medulla and spinal cord. Consider 61345 for a different posterior fossa decompression that does not match that specific service.
- 61340Cranial decompression
- 61340 is subtemporal decompression, not decompression at the foramen magnum with upper cervical bone removal.
- 63045Cervical decompression
- 63045 describes cervical spinal decompression for a cervical spine condition. Use 61343 when the cervical laminectomy is part of the suboccipital cervicomedullary decompression.
61343 billing questions
When is 61343 preferable to another posterior fossa decompression code?
Use 61343 when the operative service is suboccipital decompression with cervical laminectomy to relieve pressure on the medulla and spinal cord. A different posterior fossa decompression may be classified under 61345 when it does not match that service.
Can the cervical laminectomy be billed separately?
The cervical bone removal performed as part of this cervicomedullary decompression is included in the service. Do not report a separate laminectomy for the same decompression.
Should modifier 50 be used for a bilateral procedure?
No. Modifier 50 is inappropriate for this code.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% 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 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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