Billing code 61595: Skull base approachMedicare rate & RVUs in Ohio
Reports a transtemporal route to the posterior cranial fossa, jugular foramen, or midline skull base, including mastoidectomy and facial nerve work.
CMS doesn’t publish an office rate for 61595 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 61595 covers
This code describes surgical access through the temporal bone toward the posterior cranial fossa, jugular foramen, or midline skull base. The approach includes mastoidectomy and decompression of the facial nerve, with or without facial nerve mobilization. It is typically performed in an operating room by an otologic or skull-base surgeon, often working with a neurosurgeon, to expose a lesion or other surgical target in these regions.
Report the approach when the operative record identifies the transtemporal route and supports the included bone and facial nerve work; the code represents access, not removal of the lesion. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, payment is 150%. Assistant-at-surgery payment is barred by statutory restriction; 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.
61595 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $2,118.44 |
How the 61595 rate is calculated
Each of 61595’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 · 61595
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 32.90Practice expense 24.06Malpractice 8.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61595
61595 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61595
Skull base approach
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 61595
Skull base approach
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
61595 without 50 · national facility
$2,186.09
Skull base approach
61595-50 · Bilateral: 150%
$3,279.14
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).
61595 compared with similar codes
Compare codes
61595 vs 61596 vs 61597 vs 61590: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61596Skull base approach
- 61595 describes a transtemporal approach with mastoidectomy and facial nerve decompression. 61596 is the transcochlear approach.
- 61597Skull-base approach
- Use 61595 for the transtemporal route; 61597 identifies a transcondylar route to the posterior fossa.
- 61590Skull base approach
- 61590 describes an infratemporal preauricular route to the middle cranial fossa, rather than the transtemporal route represented by 61595.
61595 billing questions
How does this differ from the transcochlear approach?
61595 uses a transtemporal route and includes mastoidectomy with facial nerve decompression, with or without mobilization. 61596 identifies a transcochlear route.
Does this code include removal of the skull-base lesion?
No. It describes the transtemporal surgical access; code the definitive lesion treatment separately when performed and separately reportable.
Is mastoidectomy separately reported with 61595?
Mastoidectomy is included in this approach code, along with facial nerve decompression and any mobilization.
Can modifier 50 be used for bilateral reporting?
CMS identifies this as a bilateral procedure. With modifier 50, payment is 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is barred by statutory restriction. Co-surgeons are paid only when supporting documentation is provided.
What documentation supports the approach?
The operative report should identify the transtemporal route and target region, and describe the mastoidectomy and facial nerve decompression or mobilization performed.
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 61595 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 →