Billing code 61556: Suture surgeryMedicare rate & RVUs in Ohio
Surgical incision of cranial bone and fused suture tissue for craniosynostosis, reported when the operative service meets this code’s specific technique and extent.
CMS doesn’t publish an office rate for 61556 in Ohio.
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 61556 covers
This operation treats craniosynostosis, in which one or more skull sutures fuse prematurely and can restrict normal skull growth. A neurosurgeon or craniofacial surgeon exposes the affected cranial region and incises the skull and fused suture as part of the operative correction. It is generally performed in a hospital operating room, often for an infant or child whose cranial growth or head shape is affected. The operative report should identify the fused suture or sutures and describe the work performed.
Select this code from the specific procedure documented, including its extent and technique; do not choose it from the diagnosis alone. Distinguish suture incision from procedures that release or excise suture-bearing bone. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Bilateral adjustment is inappropriate. 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.
61556 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,631.50 |
How the 61556 rate is calculated
Each of 61556’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 · 61556
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 23.49Practice expense 16.82Malpractice 9.92
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61556
61556 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61556
Suture surgery
| 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 · 61556
Suture surgery
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
61556 without 51 · national facility
$1,677.73
Suture surgery
61556-51 · Second procedure: 50%
$838.87
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%).
61556 compared with similar codes
Compare codes
61556 vs 61550 vs 61552 vs 61558: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61550Craniosynostosis surgery
- Both belong to the craniosynostosis craniectomy family. Use the code whose full descriptor matches the suture extent and operative service documented.
- 61552Suture release
- This is a related craniosynostosis procedure, but the code choice depends on the specific procedure and extent in the operative report.
- 61558Craniosynostosis surgery
- 61558 represents excision of skull or suture tissue. Choose 61556 when the documented service is the incision-based procedure described by this code.
61556 billing questions
What documentation supports reporting this code?
The operative report should document craniosynostosis, the affected suture or sutures, and the specific incision or craniectomy performed. The diagnosis alone does not establish that this procedure was performed.
How does this differ from a skull-suture release code?
Choose this code when the documented procedure matches its specific incision-based service. Compare the operative technique and extent with the release codes in the craniosynostosis family rather than relying only on the diagnosis.
Can the bone graft or reconstruction be billed separately?
The provided CMS facts do not establish separate reporting for grafting or reconstruction. Review the full code descriptor and the operative documentation before assigning an additional code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. The surgeon’s related routine follow-up during that period is part of the global service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures performed in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the others are subject to a 50% reduction. Modifier 50 is inappropriate for this code.
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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