Billing code 61592: Skull base approachMedicare rate & RVUs in Oregon
Reports an orbitocranial zygomatic route to the middle cranial fossa when the operation requires this specialized skull-base exposure.
CMS doesn’t publish an office rate for 61592 in Oregon.
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 61592 covers
This code describes a surgical exposure to the middle cranial fossa through an orbitocranial zygomatic route, with operative work that may include elevation of the temporal lobe. Neurosurgeons and skull-base surgeons use this approach when the planned operation requires access through this corridor; it is typically performed in a hospital operating room. The operative report should identify the route and describe the exposure performed, rather than relying only on the underlying diagnosis or lesion location.
Select 61592 based on the approach documented, distinguishing it from anterior-fossa orbitocranial and other middle-fossa corridors. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.
Where 61592 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $3,039.31 |
| Rest Of Oregon | Unavailable | $2,869.19 |
How the 61592 rate is calculated
Each of 61592’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 · 61592
RVUs × geographic indexes × conversion factor
Work42.00
42.00 RVUs× 1.000 GPCI
Practice expense32.70
32.70 RVUs× 1.000 GPCI
Malpractice16.12
16.12 RVUs× 1.000 GPCI
Adjusted RVUs
90.8200
Conversion factor
$33.4009
Medicare rate
$3,033.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61592
61592 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61592
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) | 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 · 61592
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
61592 without 50 · national facility
$3,033.47
Skull base approach
61592-50 · Bilateral: 150%
$4,550.20
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).
61592 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61584Skull base approach
- Both are orbitocranial approach codes, but 61592 identifies the zygomatic route to the middle cranial fossa. Use the operative report to distinguish the approach.
- 61585Orbitocranial approach
- This is another orbitocranial skull-base approach code. The documented route and operative exposure, rather than the diagnosis alone, guide code selection.
- 61590Skull base approach
- 61590 describes an infratemporal approach to the middle cranial fossa. 61592 is the orbitocranial zygomatic route.
- 61595Skull base approach
- 61595 describes a transtemporal skull-base route, not the orbitocranial zygomatic exposure represented by 61592.
61592 billing questions
How is 61592 distinguished from 61584 and 61585?
61592 describes an orbitocranial zygomatic route to the middle cranial fossa. Choose among these codes from the specific approach documented, not simply because the operation involves the orbit or skull base.
Does 61592 identify the approach or the lesion removal?
It identifies the orbitocranial zygomatic approach. The operative report should also make clear what definitive procedure was performed; do not infer lesion removal from the approach code alone.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral reporting handled?
When the procedure is bilateral and reported with modifier 50, Medicare pays 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team surgery is permitted.
How does Medicare handle other procedures performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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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