Billing code 61558: Craniosynostosis surgeryMedicare rate & RVUs in Utah
Reports cranial surgery for craniosynostosis involving excision of fused suture-bearing bone, selected from the documented operative approach and reconstruction.
CMS doesn’t publish an office rate for 61558 in Utah.
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 61558 covers
This code describes open cranial surgery to treat craniosynostosis by removing fused suture-bearing bone as part of cranial vault correction. Pediatric neurosurgeons and craniofacial surgeons typically perform the operation in a hospital operating room. The operative report should identify the affected sutures and explain the bone excision and reconstructive work performed; the diagnosis alone does not establish that this specific procedure was done.
Select the code that matches the documented surgical technique and extent, distinguishing excision from procedures limited to releasing or incising fused sutures. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons require 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.
61558 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,774.91 |
How the 61558 rate is calculated
Each of 61558’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 · 61558
RVUs × geographic indexes × conversion factor
Work25.84
25.84 RVUs× 1.000 GPCI
Practice expense18.61
18.61 RVUs× 1.000 GPCI
Malpractice10.92
10.92 RVUs× 1.000 GPCI
Adjusted RVUs
55.3700
Conversion factor
$33.4009
Medicare rate
$1,849.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61558
61558 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61558
Craniosynostosis 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) | 1 | Permitted with supporting documentation. |
| 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 · 61558
Craniosynostosis 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
61558 without 51 · national facility
$1,849.41
Craniosynostosis surgery
61558-51 · Second procedure: 50%
$924.71
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%).
61558 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61550Craniosynostosis surgery
- This code concerns excision of suture-bearing bone during craniosynostosis surgery. Code 61550 represents release of a single cranial suture.
- 61552Suture release
- Code 61552 describes release involving multiple cranial sutures; use this code when the documented operation supports the excision procedure instead.
- 61556Suture surgery
- Code 61556 is an incision-based craniosynostosis procedure. Distinguish it from this code by the operative technique and work documented.
- 61563Skull tumor excision
- Code 61563 concerns excision of a skull tumor. This code is for craniosynostosis surgery, not removal of a skull neoplasm.
61558 billing questions
How is this code distinguished from a suture-release procedure?
Use this code when the operative report supports excision of fused suture-bearing bone as part of the craniosynostosis operation. Procedures limited to releasing or incising sutures are represented by different codes.
What documentation supports reporting this procedure?
Document the craniosynostosis, the affected suture or sutures, the bone excised, and the reconstructive steps performed. The operative details should support the specific technique selected.
Does the code include postoperative care?
Yes. CMS assigns a 90-day global period that includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation; team surgery 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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