Billing code 61460: Cranial nerve surgeryMedicare rate & RVUs in Texas
Reports a suboccipital craniectomy performed to section one or more cranial nerves, rather than to explore or decompress them.
CMS doesn’t publish an office rate for 61460 in Texas.
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 61460 covers
A neurosurgeon uses a suboccipital approach to reach and intentionally divide one or more cranial nerves inside the skull. The operation is distinct from opening the area only to inspect or decompress a nerve. A posterior fossa nerve section for selected cases of severe, otherwise difficult-to-control cranial neuralgia is a representative clinical context. This service is generally performed in a hospital operating room.
Choose the code from the operative objective and documented work: cranial nerve section through a suboccipital craniectomy. The operative report should identify the nerve or nerves treated and document that sectioning was performed, rather than decompression alone. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. An assistant at surgery may be paid, and co-surgeons are permitted; team-surgery payment is not permitted. Modifier 50 is inappropriate for this descriptor.
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 61460 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $2,040.21 |
| Beaumont | Unavailable | $1,960.34 |
| Brazoria | Unavailable | $1,958.64 |
| Dallas | Unavailable | $1,995.32 |
| Fort Worth | Unavailable | $1,994.26 |
| Galveston | Unavailable | $1,979.91 |
| Houston | Unavailable | $2,207.97 |
| Rest Of Texas | Unavailable | $1,974.76 |
How the 61460 rate is calculated
Each of 61460’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 · 61460
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 29.48Practice expense 19.38Malpractice 12.46
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61460
61460 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61460
Cranial nerve surgery
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not 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 · 61460
Cranial nerve surgery
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 51 · payment effect
With and without the modifier
61460 without 51 · national facility
$2,048.14
Cranial nerve surgery
61460-51 · Second procedure: 50%
$1,024.07
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
61460 compared with similar codes
Compare codes
61460 vs 61458 vs 61450: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61458Nerve decompression
- 61458 is for suboccipital exploration or decompression of cranial nerves. Choose 61460 when the operative report documents nerve section.
- 61450Cranial nerve section
- 61450 is directed to decompression of the medulla and spinal cord. It does not describe sectioning cranial nerves.
61460 billing questions
How is this code distinguished from 61458?
Use 61460 when the suboccipital operation sections one or more cranial nerves. Code 61458 describes exploration or decompression of cranial nerves, not their section.
When is 61450 a better fit?
61450 concerns suboccipital decompression of the medulla and spinal cord. Select 61460 when the documented operative objective is cranial nerve section.
What documentation supports reporting 61460?
The operative report should establish the suboccipital approach and state that one or more cranial nerves were intentionally sectioned. A diagnosis or mention of neuralgia alone does not establish that operative work.
Can modifier 50 be reported?
No. The code’s descriptor and anatomy make modifier 50 inappropriate.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons for this code. Team-surgery payment is not 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 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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