Billing code 61580: Craniofacial approachMedicare rate & RVUs in Texas
Reports an extradural craniofacial route to the anterior cranial fossa, typically for lesions involving the anterior skull base and adjacent sinonasal region.
CMS doesn’t publish an office rate for 61580 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 61580 covers
This service creates combined cranial and facial access to the anterior cranial fossa. The surgeon elevates the frontal lobes, performs a craniotomy and facial bone osteotomies, and works in the extradural plane. It is used for selected anterior skull-base lesions, including tumors extending between the intracranial and sinonasal spaces. Neurosurgeons and head-and-neck or craniofacial surgeons may participate, commonly in a hospital operating room. The approach described here does not include maxillectomy or orbital exenteration.
Report 61580 when the operative record supports this extradural approach and its documented extent; distinguish it from an intradural approach such as 61581. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 is restricted; co-surgeon payment requires supporting documentation, while team surgery is permitted.
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 61580 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 | $2,243.89 |
| Beaumont | Unavailable | $2,124.43 |
| Brazoria | Unavailable | $2,168.15 |
| Dallas | Unavailable | $2,191.87 |
| Fort Worth | Unavailable | $2,186.32 |
| Galveston | Unavailable | $2,181.13 |
| Houston | Unavailable | $2,309.62 |
| Rest Of Texas | Unavailable | $2,151.88 |
How the 61580 rate is calculated
Each of 61580’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 · 61580
RVUs × geographic indexes × conversion factor
Work33.65
33.65 RVUs× 1.000 GPCI
Practice expense25.75
25.75 RVUs× 1.000 GPCI
Malpractice7.02
7.02 RVUs× 1.000 GPCI
Adjusted RVUs
66.4200
Conversion factor
$33.4009
Medicare rate
$2,218.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61580
61580 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61580
Craniofacial approach
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 2 | 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 · 61580
Craniofacial approach
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 50 · payment effect
With and without the modifier
61580 without 50 · national facility
$2,218.49
Craniofacial approach
61580-50 · Bilateral: 150%
$3,327.73
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
61580 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61581Craniofacial approach
- The key distinction is the operative plane: 61580 is extradural, whereas 61581 is used for the intradural approach.
- 61584Skull base approach
- 61584 describes an orbitocranial approach. Choose 61580 for the documented craniofacial route to the anterior cranial fossa.
- 61586Skull-base resection
- 61586 concerns skull-base resection involving the nasopharynx. It is not the code for the extradural anterior craniofacial approach described by 61580.
61580 billing questions
How is 61580 distinguished from 61581?
61580 describes an extradural anterior craniofacial approach. Use the intradural code when the documented approach includes work within the dura.
Does this code describe removal of the lesion?
The code identifies the specified craniofacial approach. The operative report should separately establish the definitive work performed and support any additional reported service.
What documentation supports 61580?
Document the anterior cranial fossa exposure, extradural plane, craniotomy, facial bone osteotomies, frontal lobe elevation, and the structures or lesion reached.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. 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 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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