No office rate
This code describes the extradural orbitocranial route to the anterior cranial fossa. 61585 is the intradural counterpart.
On this page
CMS RVU26D · Effective 2026-10-01
61584 Skull base approach Medicare reimbursement rates in Rhode Island
Reports an extradural orbitocranial route to the anterior cranial fossa using orbital osteotomy, typically to expose lesions at the anterior skull base. Compare 61584 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 61584 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
$2840.11
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.
Skull base surgery
About 61584: Orbitocranial anterior fossa approach
Reports an extradural orbitocranial route to the anterior cranial fossa using orbital osteotomy, typically to expose lesions at the anterior skull base.
This code describes an extradural surgical corridor to the anterior cranial fossa created through an orbitocranial approach with orbital osteotomy and elevation of the frontal lobe. Neurosurgeons commonly perform the approach for operations involving anterior skull base lesions, sometimes with an otolaryngologist or craniofacial surgeon participating. It is generally performed in a hospital operating room rather than an office setting.
Select this code when the operative report supports the anterior fossa target, extradural route, and orbital osteotomy; an intradural route is a different service. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is permitted.
CMS billing rules for 61584
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery permitted.
Where the value comes from
- Work RVU36.76 · 43%
- Practice expense (office) RVU33.67 · 40%
- Malpractice RVU14.34 · 17%
283
Medicare services in 2024 · #4038 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.
61584 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
61580 describes a craniofacial route to the anterior cranial fossa. 61584 specifies an orbitocranial route with orbital osteotomy.
No office rate
Both involve an orbitocranial approach, but 61592 is directed to a different cranial fossa target. Base selection on the operative corridor and target.
Compare 61584 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
$2840.11
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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 61584 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,825
- Code
- 61584
- Physician work
- 36.76
- Practice expense
- 33.67
- Malpractice
- 14.34
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.76 | × 1.019 | 37.4584 |
| Practice expense | 33.67 | × 1.033 | 34.7811 |
| Malpractice | 14.34 | × 0.892 | 12.7913 |
| Total RVUs | 85.0308 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$2840.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.76 | 1.019 |
| Practice expense | 33.67 | 1.033 |
| Malpractice | 14.34 | 0.892 |
(36.76 × 1.019 + 33.67 × 1.033 + 14.34 × 0.892) × $33.4009 = $2840.11
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.
61584 billing questions
How does 61584 differ from 61585?
Both describe an orbitocranial approach to the anterior cranial fossa with orbital osteotomy. Choose 61584 for an extradural route and 61585 for an intradural route.
What operative documentation supports 61584?
The operative report should identify the anterior cranial fossa target, the extradural corridor, the orbital osteotomy, and the frontal-lobe elevation performed as part of the approach.
Does the approach code include the lesion resection?
The code describes the surgical approach, not the identity of the lesion or the full extent of its treatment. Review the operative work and applicable CPT instructions when determining whether another procedure code is reportable.
When is modifier 50 appropriate?
Use modifier 50 when the documented service is performed bilaterally. CMS pays a bilateral procedure reported with modifier 50 at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is permitted.
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.
6,82261581,,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
6,82661585,,Orbitocranial approach/skull,A,,41.51,38.43,NA,38.43,,17.52,97.46,97.46,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82761586,,Resect nasopharynx skull,A,,26.79,40.91,NA,40.91,,11.32,79.02,79.02,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82861590,,Infratemporal approach/skull,A,,45.86,24.78,NA,24.78,,9.17,79.81,79.81,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,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