Billing code 61564: Skull tumor excisionMedicare rate & RVUs in Ohio
Reports operative removal of a tumor arising in the skull, such as a calvarial lesion, rather than a tumor excised from brain tissue.
CMS doesn’t publish an office rate for 61564 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 61564 covers
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 billing code 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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $2,273.87 |
How the 61564 rate is calculated
Each of 61564’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 · 61564
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 33.87Practice expense 21.68Malpractice 14.30
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61564
61564 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61564
Skull tumor excision
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 61564
Skull tumor excision
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 50 · payment effect
With and without the modifier
61564 without 50 · national facility
$2,333.05
Skull tumor excision
61564-50 · Bilateral: 150%
$3,499.58
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
61564 compared with similar codes
Compare codes
61564 vs 61563 vs 61500 vs 61545: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61563Skull tumor excision
- The CMS short descriptor also identifies skull-tumor excision. The short descriptor does not explain the distinction; use the full billing code descriptor and operative report.
- 61500Skull lesion excision
- This code describes craniectomy for a benign skull lesion, cyst, or other lesion. Choose based on the applicable billing code descriptor and the documented lesion and service.
- 61545Brain tumor surgery
- This is for excision of a brain tumor. 61564 concerns a tumor arising in the skull, as established by the operative report.
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 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 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
Fee sheets
Put 61564 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →