Billing code 61586: Skull-base resectionMedicare rate & RVUs in Ohio
Reports surgical removal of a lesion involving the nasopharynx and skull base, typically performed by a multidisciplinary skull-base team in a hospital operating room.
CMS doesn’t publish an office rate for 61586 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 61586 covers
This code describes a major operation to remove a lesion involving both the nasopharynx and skull base. The surgeon’s work is directed at resection, rather than biopsy alone. Cases may involve an otolaryngologist or head-and-neck surgeon working with a neurosurgeon, particularly when the lesion extends toward the cranial base. A nasopharyngeal tumor with skull-base extension, such as a juvenile nasopharyngeal angiofibroma, is a representative clinical situation. These operations are generally performed in a hospital operating room.
Select the code when the operative report supports removal of the lesion at the nasopharynx-skull-base site; document the extent, structures addressed, and resection performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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% multiple procedure reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is 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.
61586 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $2,523.48 |
How the 61586 rate is calculated
Each of 61586’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 · 61586
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 26.79Practice expense 40.91Malpractice 11.32
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61586
61586 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61586
Skull-base resection
| 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) | 2 | 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 · 61586
Skull-base resection
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
61586 without 51 · national facility
$2,639.34
Skull-base resection
61586-51 · Second procedure: 50%
$1,319.67
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%).
61586 compared with similar codes
Compare codes
61586 vs 61575 vs 61580 vs 61590: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61575Transoral skull-base surgery
- This code concerns resection involving the nasopharynx and skull base. Code 61575 describes a transoral route to the skull base, brainstem, or upper spinal cord.
- 61580Craniofacial approach
- Code 61580 describes craniofacial access to the anterior cranial fossa. Choose based on the operation and route documented, rather than treating the codes as interchangeable.
- 61590Skull base approach
- Code 61590 describes an infratemporal approach. This code identifies resection involving the nasopharynx and skull base, so the operative target and route help distinguish them.
61586 billing questions
How is this distinguished from a skull-base approach code?
This code represents resection of a lesion involving the nasopharynx and skull base. Approach codes describe a particular route used to reach the skull base; use the operative details to identify the service performed.
Does the 90-day global period include postoperative visits?
Yes. Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this service. Co-surgeon payment requires supporting documentation.
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.
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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