No office rate
Both belong to the craniosynostosis craniectomy family. Use the code whose full descriptor matches the suture extent and operative service documented.
On this page
CMS RVU26D · Effective 2026-10-01
61556 Suture surgery Medicare reimbursement rates in Oregon
Surgical incision of cranial bone and fused suture tissue for craniosynostosis, reported when the operative service meets this code’s specific technique and extent. Compare 61556 office and facility rates across CMS payment localities in Oregon.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 61556 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1577.07–$1667.82
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Neurosurgery
About 61556: Craniosynostosis cranial suture craniectomy
Surgical incision of cranial bone and fused suture tissue for craniosynostosis, reported when the operative service meets this code’s specific technique and extent.
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.
CMS billing rules for 61556
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.49 · 47%
- Practice expense (office) RVU16.82 · 33%
- Malpractice RVU9.92 · 20%
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 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
This is a related craniosynostosis procedure, but the code choice depends on the specific procedure and extent in the operative report.
No office rate
61558 represents excision of skull or suture tissue. Choose 61556 when the documented service is the incision-based procedure described by this code.
Compare 61556 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Portland →
Office / nonfacility
Unavailable
Facility
$1667.82
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$1577.07
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,80661548,,Removal of pituitary gland,A,,22.79,13.62,NA,13.62,,8.11,44.52,44.52,0,090,0.11,0.76,0.13,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,80761550,,Release of skull seams,A,,15.20,14.87,NA,14.87,,6.41,36.48,36.48,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,80861552,,Release of skull seams,A,,19.89,16.01,NA,16.01,,8.38,44.28,44.28,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,80961556,,Incise skull/sutures,A,,23.49,16.82,NA,16.82,,9.92,50.23,50.23,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81061557,,Incise skull/sutures,A,,22.73,17.76,NA,17.76,,9.60,50.09,50.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81161558,,Excision of skull/sutures,A,,25.84,18.61,NA,18.61,,10.92,55.37,55.37,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81261559,,Excision of skull/sutures,A,,33.17,23.00,NA,23.00,,14.00,70.17,70.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00