CPT code 61450: Cranial nerve section2026 Medicare rate & RVUs in Nebraska
Reports a suboccipital craniectomy performed to intentionally section cranial nerve tissue, such as for selected cases of refractory cranial neuralgia.
CMS doesn’t publish an office rate for 61450 in Nebraska.
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 61450 covers
The surgeon removes bone beneath the back of the skull to reach and intentionally divide one or more cranial nerves. This approach may be used for selected patients with severe, refractory cranial neuralgia when nerve section is the planned treatment. The operative report should identify the nerve or nerves treated and describe the sectioning performed; exploration or decompression without nerve section is a different service. Neurosurgeons typically perform this procedure in a hospital operating room.
Report 61450 when the documented work matches suboccipital access and cranial nerve section, rather than exploration or decompression alone. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery 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.
61450 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $1,583.85 |
How the 61450 rate is calculated
Each of 61450’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 · 61450
RVUs × geographic indexes × conversion factor
Work27.00
27.00 RVUs× 1.000 GPCI
Practice expense17.45
17.45 RVUs× 1.000 GPCI
Malpractice11.41
11.41 RVUs× 1.000 GPCI
Adjusted RVUs
55.8600
Conversion factor
$33.4009
Medicare rate
$1,865.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61450
61450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61450
Cranial nerve section
| 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 · 61450
Cranial nerve section
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
61450 without 51 · national facility
$1,865.77
Cranial nerve section
61450-51 · Second procedure: 50%
$932.89
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%).
61450 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61458Nerve decompression
- Use 61450 when the surgeon intentionally sections cranial nerve tissue through a suboccipital approach. Use 61458 for cranial nerve exploration or decompression.
- 61460Cranial nerve surgery
- This is a related suboccipital cranial nerve procedure with a distinct descriptor. Match code selection to the specific nerve procedure and extent documented in the operative report.
- 61790Trigeminal nerve treatment
- 61790 represents percutaneous stereotactic radiofrequency lesioning, a different approach that may address selected trigeminal neuralgia cases; 61450 involves suboccipital surgery and nerve section.
61450 billing questions
How does 61450 differ from 61458?
61450 describes suboccipital surgery that sections cranial nerve tissue. 61458 is for suboccipital exploration or decompression of cranial nerves, not nerve section.
Is the suboccipital bone removal separately reported?
The craniectomy is part of the service represented by 61450. Do not report a separate craniectomy code for the same operative access.
Should modifier 50 be used for bilateral nerve section?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the documented operative work.
What documentation supports 61450?
The operative report should establish the suboccipital approach and intentional sectioning of one or more cranial nerves, identifying the treated nerve or nerves.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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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