No office rate
The CMS short descriptor also identifies skull-tumor excision. The short descriptor does not explain the distinction; use the full CPT descriptor and operative report.
On this page
CMS RVU26D · Effective 2026-10-01
61564 Skull tumor excision Medicare reimbursement rates in Maine
Reports operative removal of a tumor arising in the skull, such as a calvarial lesion, rather than a tumor excised from brain tissue. Compare 61564 office and facility rates across CMS payment localities in Maine.
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 61564 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2094.58–$2150.29
2 of 2 localities have a supported rate.
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 61564: Craniectomy for skull tumor excision
Reports operative removal of a tumor arising in the skull, such as a calvarial lesion, rather than a tumor excised from brain tissue.
A neurosurgeon or other cranial surgeon uses a craniectomy to remove a tumor arising in the skull bone. A calvarial metastasis or a primary bone tumor involving the skull are representative clinical situations. The service is performed in an operating room, generally in a hospital or surgical facility, with the operative report establishing that the lesion originates in the skull rather than the brain.
Select the code supported by the operative details and the applicable CPT distinction from other skull-tumor excision codes. Documentation should identify the lesion’s site and origin, the surgical work performed, and the tissue removed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. 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. For a bilateral procedure reported with modifier 50, payment is at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 61564
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU33.87 · 48%
- Practice expense (office) RVU21.68 · 31%
- Malpractice RVU14.30 · 20%
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.
61564 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
This code describes craniectomy for a benign skull lesion, cyst, or other lesion. Choose based on the applicable CPT descriptor and the documented lesion and service.
No office rate
This is for excision of a brain tumor. 61564 concerns a tumor arising in the skull, as established by the operative report.
Compare 61564 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$2094.58
Southern Maine →
Office / nonfacility
Unavailable
Facility
$2150.29
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61564 billing questions
How do I distinguish a skull tumor from a brain tumor for this code?
The operative report should show that the tumor arises in the skull bone and is excised there. A tumor excised from brain tissue points to a brain-tumor procedure instead.
How is 61564 distinguished from 61563?
CMS gives both codes the same short descriptor, so that label alone does not establish which code fits. Use the full CPT code distinction and the operative details when selecting between them.
What documentation supports reporting 61564?
Document the tumor’s anatomic site and origin in the skull, the craniectomy and excision performed, and the tissue removed. The record should make clear that the target was skull bone, not brain tissue.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
What payment rules apply when other procedures or surgeons are involved?
In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment needs supporting documentation, while 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 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.
6,81161558,,Excision of skull/sutures,A,,25.84,18.61,NA,18.61,,10.92,55.37,55.37,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81261559,,Excision of skull/sutures,A,,33.17,23.00,NA,23.00,,14.00,70.17,70.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81361563,,Excision of skull tumor,A,,27.73,18.31,NA,18.31,,11.72,57.76,57.76,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81461564,,Excision of skull tumor,A,,33.87,21.68,NA,21.68,,14.30,69.85,69.85,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81561566,,Removal of brain tissue,A,,31.64,20.04,NA,20.04,,13.37,65.05,65.05,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81661567,,Incision of brain tissue,A,,36.08,22.75,NA,22.75,,15.23,74.06,74.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81761570,,Remove foreign body brain,A,,25.85,18.10,NA,18.10,,10.93,54.88,54.88,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00