No office rate
Both are orbitocranial approach codes, but 61592 identifies the zygomatic route to the middle cranial fossa. Use the operative report to distinguish the approach.
On this page
CMS RVU26D · Effective 2026-10-01
61592 Skull base approach Medicare reimbursement rates in Rhode Island
Reports an orbitocranial zygomatic route to the middle cranial fossa when the operation requires this specialized skull-base exposure. Compare 61592 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 61592 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
$3038.02
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 61592: Orbitocranial zygomatic middle fossa approach
Reports an orbitocranial zygomatic route to the middle cranial fossa when the operation requires this specialized skull-base exposure.
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.
CMS billing rules for 61592
- 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 RVU42.00 · 46%
- Practice expense (office) RVU32.70 · 36%
- Malpractice RVU16.12 · 18%
320
Medicare services in 2024 · #3950 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.
61592 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
This is another orbitocranial skull-base approach code. The documented route and operative exposure, rather than the diagnosis alone, guide code selection.
No office rate
61590 describes an infratemporal approach to the middle cranial fossa. 61592 is the orbitocranial zygomatic route.
No office rate
61595 describes a transtemporal skull-base route, not the orbitocranial zygomatic exposure represented by 61592.
Compare 61592 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
$3038.02
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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 61592 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,830
- Code
- 61592
- Physician work
- 42.00
- Practice expense
- 32.70
- Malpractice
- 16.12
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.00 | × 1.019 | 42.7980 |
| Practice expense | 32.70 | × 1.033 | 33.7791 |
| Malpractice | 16.12 | × 0.892 | 14.3790 |
| Total RVUs | 90.9561 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$3038.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 42 | 1.019 |
| Practice expense | 32.7 | 1.033 |
| Malpractice | 16.12 | 0.892 |
(42 × 1.019 + 32.7 × 1.033 + 16.12 × 0.892) × $33.4009 = $3038.02
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.
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 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.
6,82761586,,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
6,82961591,,Infratemporal approach/skull,A,,45.84,26.12,NA,26.12,,11.25,83.21,83.21,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83061592,,Orbitocranial approach/skull,A,,42.00,32.70,NA,32.70,,16.12,90.82,90.82,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83161595,,Transtemporal approach/skull,A,,32.90,24.06,NA,24.06,,8.49,65.45,65.45,0,090,0.11,0.76,0.13,2,1,1,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83261596,,Transcochlear approach/skull,A,,38.44,18.52,NA,18.52,,5.60,62.56,62.56,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,83361597,,Transcondylar approach/skull,A,,39.80,32.18,NA,32.18,,16.81,88.79,88.79,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,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