No office rate
Use 61584 when the documented route is orbitocranial. This code is for the craniofacial approach to the anterior cranial fossa.
On this page
CMS RVU26D · Effective 2026-10-01
61581 Craniofacial approach Medicare reimbursement rates in Rhode Island
Reports a craniofacial surgical route to the anterior cranial fossa when a lesion requires access through the cranial and facial regions. Compare 61581 office and facility rates across CMS payment localities in Rhode Island.
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 61581 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2393.57
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 61581: Craniofacial anterior skull base approach
Reports a craniofacial surgical route to the anterior cranial fossa when a lesion requires access through the cranial and facial regions.
This code describes a craniofacial route for reaching the anterior cranial fossa, where a lesion may involve the skull base near the nasal cavity or paranasal sinuses. The operation combines cranial and facial exposure; a neurosurgeon may work with an otolaryngologist or another surgeon experienced in skull base surgery. It is generally performed in a hospital operating room for complex skull base disease, rather than as an office procedure.
Select the code from the operative report’s documented approach and the specific work performed, not simply the diagnosis or lesion location. The record should identify the cranial and facial exposure and the target area. Medicare assigns 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 the others at 50%. Modifier 50 results in payment at 150% for a bilateral procedure. Co-surgeons and team surgery are permitted; assistant-at-surgery services are subject to a statutory payment restriction.
CMS billing rules for 61581
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery permitted.
Where the value comes from
- Work RVU38.15 · 54%
- Practice expense (office) RVU26.93 · 38%
- Malpractice RVU5.57 · 8%
54
Medicare services in 2024 · #5313 by national volume
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.
61581 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
61590 describes an infratemporal approach. Choose this code when the operative report documents a craniofacial route to the anterior cranial fossa.
No office rate
61580 is a neighboring craniofacial approach code. Distinguish it from 61581 by the specific approach variant documented in the operative report.
Compare 61581 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$2393.57
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 61581 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,822
- Code
- 61581
- Physician work
- 38.15
- Practice expense
- 26.93
- Malpractice
- 5.57
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 38.15 | × 1.019 | 38.8748 |
| Practice expense | 26.93 | × 1.033 | 27.8187 |
| Malpractice | 5.57 | × 0.892 | 4.9684 |
| Total RVUs | 71.6620 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$2393.57
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 38.15 | 1.019 |
| Practice expense | 26.93 | 1.033 |
| Malpractice | 5.57 | 0.892 |
(38.15 × 1.019 + 26.93 × 1.033 + 5.57 × 0.892) × $33.4009 = $2393.57
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
61581 billing questions
How is this different from an orbitocranial approach?
This code identifies a craniofacial route to the anterior cranial fossa. Codes 61584, 61585, and 61592 identify orbitocranial approaches; select according to the approach documented in the operative report.
What documentation supports reporting this approach?
The operative report should describe the cranial and facial exposure and identify the anterior cranial fossa target. The diagnosis alone does not establish which approach code applies.
Can co-surgeons report this service?
CMS permits co-surgeons for this code. The record should support each surgeon’s distinct role in the operation.
Can an assistant-at-surgery be paid for this code?
CMS lists a statutory restriction on assistant-at-surgery payment for this service.
How are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in the same session are paid at 50%. Related postoperative care is included in the 90-day global period.
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.
6,81961575,,Skull base/brainstem surgery,A,,35.65,21.54,NA,21.54,,15.05,72.24,72.24,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82061576,,Skull base/brainstem surgery,A,,53.93,48.90,NA,48.90,,22.75,125.58,125.58,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82161580,,Craniofacial approach skull,A,,33.65,25.75,NA,25.75,,7.02,66.42,66.42,0,090,0.11,0.76,0.13,2,1,1,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82261581,,Craniofacial approach skull,A,,38.15,26.93,NA,26.93,,5.57,70.65,70.65,0,090,0.11,0.76,0.13,2,1,1,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82361582,,Craniofacial approach skull,A,,34.26,44.35,NA,44.35,,13.53,92.14,92.14,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82461583,,Craniofacial approach skull,A,,37.54,34.62,NA,34.62,,15.37,87.53,87.53,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82561584,,Orbitocranial approach/skull,A,,36.76,33.67,NA,33.67,,14.34,84.77,84.77,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537