CPT code 61321: Abscess drainage2026 Medicare rate & RVUs in Utah

Reports open surgical drainage of an intracranial abscess below the tentorium, such as a cerebellar abscess, through a craniotomy or craniectomy.

CMS RVU26DEffective Oct 1, 20261 payment locality20 Medicare services in 2024

CMS doesn’t publish an office rate for 61321 in Utah.

—Office (non-facility)
$1,987.05Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 61321 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 61321 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 61321 covers

A neurosurgeon uses a craniotomy or craniectomy to reach and drain an abscess in the infratentorial compartment, which includes the posterior fossa and cerebellum. The operation is typically performed in a hospital operating room for a patient with an intracranial infection requiring open surgical drainage. This code distinguishes infratentorial abscess drainage from drainage of a supratentorial abscess.

Select the code based on the abscess location and the procedure performed, not merely on the incision site or the presence of infection. The operative report should identify the infratentorial target and document surgical drainage. The service has a 90-day global period, including 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%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not 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.

61321 in Utah

61321 office and facility rates by payment locality
Payment localityOfficeFacility
UtahUnavailable$1,987.05

How the 61321 rate is calculated

Each of 61321’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 · 61321

RVUs × geographic indexes × conversion factor

Work29.77

29.77 RVUs× 1.000 GPCI

Practice expense19.60

19.60 RVUs× 1.000 GPCI

Malpractice12.58

12.58 RVUs× 1.000 GPCI

Adjusted RVUs

61.9500

Conversion factor

$33.4009

Medicare rate

$2,069.19

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 61321

61321 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 61321

Abscess drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.11/0.76/0.13Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 61321

Abscess drainage

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

61321 without 51 · national facility

$2,069.19

Abscess drainage

61321-51 · Second procedure: 50%

$1,034.60

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%).

When to use modifier 51

61321 compared with similar codes

Compare codes · National

5 codes, side by side

  • 61321

    Abscess drainage29.77 wRVU

    Not priced

  • 61320

    Abscess drainage26.73 wRVU

    Not priced

  • 61107

    Ventricular catheter4.87 wRVU

    Not priced

  • 61750

    Brain biopsy19.33 wRVU

    Not priced

  • 61314

    Hematoma evacuation25.25 wRVU

    Not priced

How to choose

61320Abscess drainage
Both codes describe open drainage of an intracranial abscess; choose 61321 for an infratentorial target and 61320 for a supratentorial target.
61107Ventricular catheter
This code describes twist-drill drainage of an intracranial collection, including an abscess; 61321 describes open drainage through a craniotomy or craniectomy.
61750Brain biopsy
This code describes stereotactic biopsy, aspiration, or excision of an intracranial lesion. Use 61321 when the abscess is drained through an open infratentorial approach.
61314Hematoma evacuation
61314 concerns evacuation of an infratentorial extradural or subdural hematoma, not drainage of an abscess.

61321 billing questions

How does this code differ from 61320?

Use 61321 for an abscess below the tentorium, such as in the posterior fossa. Code 61320 is the corresponding service for a supratentorial abscess.

What documentation supports 61321?

The operative report should establish the infratentorial location and describe the open surgical drainage. A diagnosis of intracranial abscess alone does not establish the site distinction.

Can 61321 be reported with modifier 50?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

What is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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
RVUs for 61321PPRRVU2026_Oct_nonQPP.csv, line 6,765 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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