No office rate
Both describe extradural cranial-base lesion resection, but 61605 is for the middle cranial fossa base; 61606 is for the posterior cranial fossa base.
On this page
CMS RVU26D · Effective 2026-10-01
61606 Skull-base lesion resection Medicare reimbursement rates in Montana
Reports excision of an extradural neoplastic, vascular, or infectious lesion at the posterior cranial fossa base, including drilling and any required dural repair. Compare 61606 office and facility rates across CMS payment localities in Montana.
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 61606 in Montana?
Montana 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
$2727.25
1 of 1 localities have a supported rate.
Payment area: Montana**
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 61606: Posterior cranial fossa extradural lesion resection
Reports excision of an extradural neoplastic, vascular, or infectious lesion at the posterior cranial fossa base, including drilling and any required dural repair.
A neurosurgeon or skull-base surgeon uses this code to remove a neoplastic, vascular, or infectious lesion from the extradural base of the posterior cranial fossa. The work includes drilling needed to reach or remove the lesion and may include dural repair. These operations are generally performed in a hospital operating room; the operative report should identify the lesion’s location and confirm that the treated portion was extradural.
Choose this code by the lesion’s site and operative plane, not simply because the procedure involved the posterior fossa. Document the pathology or suspected lesion type, extent of excision, bone work, and any dural repair. Medicare 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 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 payment may be available; co-surgeon payment requires supporting documentation, and team surgery is permitted.
CMS billing rules for 61606
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery permitted.
Where the value comes from
- Work RVU41.00 · 50%
- Practice expense (office) RVU26.61 · 33%
- Malpractice RVU14.07 · 17%
130
Medicare services in 2024 · #4673 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.
61606 compared with similar codes
Office rates for Montana, from the same CMS release.
No office rate
The anatomic region is the posterior cranial fossa base for both. The operative plane is the distinction: extradural for 61606 and intradural for 61608.
No office rate
61615 concerns lesion resection at the infratemporal or lateral skull base. Use 61606 for an extradural lesion at the posterior cranial fossa base.
Compare 61606 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
Montana** →
Office / nonfacility
Unavailable
Facility
$2727.25
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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 61606 in Montana**.
PPRRVU2026_Oct_nonQPP.csv
6,838
- Code
- 61606
- Physician work
- 41.00
- Practice expense
- 26.61
- Malpractice
- 14.07
GPCI2026.csv
71
- Locality
- Montana**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 41.00 | × 1.000 | 41.0000 |
| Practice expense | 26.61 | × 1.000 | 26.6100 |
| Malpractice | 14.07 | × 0.998 | 14.0419 |
| Total RVUs | 81.6519 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana**$2727.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 41 | 1 |
| Practice expense | 26.61 | 1 |
| Malpractice | 14.07 | 0.998 |
(41 × 1 + 26.61 × 1 + 14.07 × 0.998) × $33.4009 = $2727.25
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.
61606 billing questions
How does this differ from 61608?
61606 is for an extradural lesion at the posterior cranial fossa base. Use 61608 when the lesion is intradural.
When would 61605 be more appropriate?
61605 describes an extradural lesion at the base of the middle cranial fossa. The lesion’s anatomic site, rather than the general skull-base approach, distinguishes it from 61606.
What should the operative report establish?
Document the lesion’s posterior cranial fossa base location, its extradural plane, the excision performed, and the drilling and dural repair involved.
Can modifier 50 be used for bilateral work?
No. CMS identifies modifier 50 as inappropriate for this code; its descriptor and anatomy do not support a bilateral adjustment.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation.
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.
6,83561600,,Resect/excise cranial lesion,A,,29.26,21.58,NA,21.58,,6.49,57.33,57.33,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83661601,,Resect/excise cranial lesion,A,,30.36,29.56,NA,29.56,,11.95,71.87,71.87,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83761605,,Resect/excise cranial lesion,A,,31.76,19.93,NA,19.93,,5.57,57.26,57.26,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83861606,,Resect/excise cranial lesion,A,,41.00,26.61,NA,26.61,,14.07,81.68,81.68,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83961607,,Resect/excise cranial lesion,A,,39.91,23.47,NA,23.47,,11.26,74.64,74.64,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,84061608,,Resect/excise cranial lesion,A,,44.40,32.16,NA,32.16,,18.09,94.65,94.65,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,84161611,,Transect artery sinus,A,,7.22,2.53,NA,2.53,,3.04,12.79,12.79,0,ZZZ,0.00,0.00,0.00,0,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875