No office rate
Use 61544 for a brain lesion-directed operation; 61566 describes removal of a cerebral hemisphere.
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CMS RVU26D · Effective 2026-10-01
61566 Brain tissue removal Medicare reimbursement rates in Texas
Reports neurosurgical removal of a cerebral hemisphere, most often for severe, medication-resistant seizures arising from one side of the brain. Compare 61566 office and facility rates across CMS payment localities in Texas.
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 61566 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 61566 pays more and less in Texas
Neurosurgery
About 61566: Cerebral hemisphere removal surgery
Reports neurosurgical removal of a cerebral hemisphere, most often for severe, medication-resistant seizures arising from one side of the brain.
A neurosurgeon performs a major intracranial operation to remove a cerebral hemisphere. The procedure is most commonly associated with severe, medication-resistant seizures arising from one side of the brain. It takes place in an operating room, generally in a hospital, and involves removal of brain tissue rather than a focal lesion excision or an incision into brain tissue.
Report the code when the operative service is hemisphere removal, not simply because brain tissue was removed during another type of operation. The operative report should identify the indication, side, and extent of tissue removed, and support that the procedure was a hemispherectomy. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 61566
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU31.64 · 49%
- Practice expense (office) RVU20.04 · 31%
- Malpractice RVU13.37 · 21%
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.
61566 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Use 61545 when the operation excises a brain tumor. Use 61566 when the documented procedure is hemisphere removal.
No office rate
61567 concerns incision of brain tissue, while 61566 concerns removal of a cerebral hemisphere.
Compare 61566 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $2162.76 |
| Beaumont | Office Unavailable | Facility $2080.78 |
| Brazoria | Office Unavailable | Facility $2076.91 |
| Dallas | Office Unavailable | Facility $2116.15 |
| Fort Worth | Office Unavailable | Facility $2115.26 |
| Galveston | Office Unavailable | Facility $2099.69 |
| Houston | Office Unavailable | Facility $2344.41 |
| Rest Of Texas | Office Unavailable | Facility $2095.27 |
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61566 billing questions
How does this differ from removal of a brain tumor?
This code is for removal of a cerebral hemisphere. A tumor-directed code applies when the operation targets an identified brain tumor rather than removing a hemisphere.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are paid at 50% under the standard multiple procedure reduction.
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.
6,81261559,,Excision of skull/sutures,A,,33.17,23.00,NA,23.00,,14.00,70.17,70.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81361563,,Excision of skull tumor,A,,27.73,18.31,NA,18.31,,11.72,57.76,57.76,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81461564,,Excision of skull tumor,A,,33.87,21.68,NA,21.68,,14.30,69.85,69.85,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81561566,,Removal of brain tissue,A,,31.64,20.04,NA,20.04,,13.37,65.05,65.05,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81661567,,Incision of brain tissue,A,,36.08,22.75,NA,22.75,,15.23,74.06,74.06,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81761570,,Remove foreign body brain,A,,25.85,18.10,NA,18.10,,10.93,54.88,54.88,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,81861571,,Incise skull for brain wound,A,,27.71,18.76,NA,18.76,,11.72,58.19,58.19,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00