Billing code 61050: Cisternal punctureMedicare rate & RVUs in Nevada
Reports needle access to the cisterna magna to collect or drain cerebrospinal fluid for diagnostic evaluation or therapeutic treatment.
CMS doesn’t publish an office rate for 61050 in Nevada.
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 61050 covers
This service accesses the cerebrospinal fluid space at the cisterna magna through a suboccipital needle puncture. A neurosurgeon or neurologist typically performs it in a hospital or other procedural setting when fluid must be obtained for testing or drained therapeutically. The approach is distinct from sampling fluid through a lumbar puncture or entering a cerebral ventricle.
Report the service when the documented route is cisternal or suboccipital and the purpose is fluid collection or drainage. The record should identify the indication, access site, procedure performed, and whether fluid was collected or drained. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. This is a single cisternal access, so modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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.
61050 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $68.37 |
How the 61050 rate is calculated
Each of 61050’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 · 61050
RVUs × geographic indexes × conversion factor
Work1.47
1.47 RVUs× 1.000 GPCI
Practice expense0.46
0.46 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
2.0700
Conversion factor
$33.4009
Medicare rate
$69.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61050
The CMS indicators that decide how 61050 is paid alongside other services.
CMS payment indicators · 61050
Cisternal puncture
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
61050 without 51 · national facility
$69.14
Cisternal puncture
61050-51 · Second procedure: 50%
$34.57
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%).
61050 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61055Cisternal injection
- Both involve cisternal or suboccipital access, but 61055 is for injecting medication or another substance. Use 61050 for fluid collection or drainage.
- 61020Ventricular drainage
- 61020 accesses a cerebral ventricle; 61050 accesses the cisterna magna. The documented anatomical route distinguishes them.
- 62270Lumbar puncture
- 62270 describes diagnostic cerebrospinal fluid collection by lumbar puncture. Use 61050 when the documented route is cisternal or suboccipital.
61050 billing questions
How is this different from a lumbar puncture?
This code describes access to the cisterna magna by a suboccipital route. A lumbar puncture accesses cerebrospinal fluid through the lower back.
When should 61055 be reported instead?
Use 61055 when the cisternal puncture is performed to inject medication or another substance. This code is for fluid collection or drainage.
Can modifier 50 be used?
No. The cisternal access is a single-site procedure, and modifier 50 is inappropriate.
What documentation supports reporting this code?
Document the clinical indication, suboccipital or cisternal access route, and whether cerebrospinal fluid was collected or drained.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are 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 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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