No office rate
Both describe craniofacial skull approaches. Select between them using the full descriptors and the approach and operative work documented in the report.
On this page
CMS RVU26D · Effective 2026-10-01
61582 Craniofacial approach Medicare reimbursement rates in Vermont
Reports a craniofacial route to the skull base when surgery requires combined facial and cranial exposure for an anterior cranial fossa lesion. Compare 61582 office and facility rates across CMS payment localities in Vermont.
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 61582 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2839.50
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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.
Skull base surgery
About 61582: Craniofacial skull base approach
Reports a craniofacial route to the skull base when surgery requires combined facial and cranial exposure for an anterior cranial fossa lesion.
This code represents a craniofacial approach to the skull base, combining facial and cranial exposure to reach a lesion involving the anterior cranial fossa. A neurosurgeon may work with an otolaryngologist or a facial plastic surgeon when a tumor, such as an anterior skull base malignancy, requires access from both sides of the skull base. The service is generally performed in a hospital operating room and involves substantially more than a routine craniotomy or an isolated sinonasal tumor removal.
Report 61582 when the operative report supports the specific approach and work described by this code; use the complete code descriptor to distinguish it from related craniofacial approach codes. Documentation should identify the lesion, route of access, intracranial work, and surgeons’ roles. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is permitted.
CMS billing rules for 61582
- 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 permitted.
Where the value comes from
- Work RVU34.26 · 37%
- Practice expense (office) RVU44.35 · 48%
- Malpractice RVU13.53 · 15%
117
Medicare services in 2024 · #4762 by national volume
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.
61582 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This is a sibling craniofacial approach code. The operative report must support the specific variant represented by the selected code.
No office rate
This is another craniofacial approach code; distinguish it from 61582 by matching the complete descriptor to the documented operative configuration.
No office rate
61584 describes an orbitocranial route. Use 61582 when the documented approach matches its craniofacial skull-base work instead.
Compare 61582 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
Unavailable
Facility
$2839.50
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 61582 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,823
- Code
- 61582
- Physician work
- 34.26
- Practice expense
- 44.35
- Malpractice
- 13.53
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 34.26 | × 1.000 | 34.2600 |
| Practice expense | 44.35 | × 0.990 | 43.9065 |
| Malpractice | 13.53 | × 0.506 | 6.8462 |
| Total RVUs | 85.0127 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$2839.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 34.26 | 1 |
| Practice expense | 44.35 | 0.99 |
| Malpractice | 13.53 | 0.506 |
(34.26 × 1 + 44.35 × 0.99 + 13.53 × 0.506) × $33.4009 = $2839.50
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
61582 billing questions
When should 61582 be chosen over another craniofacial approach code?
Choose it when the documented approach and operative work match 61582’s full descriptor. Compare the complete descriptors for 61580, 61581, and 61583 rather than relying on their abbreviated labels.
Can the cranial and facial portions be reported separately?
61582 represents a craniofacial approach, so the operative report should support the combined route and work. Do not treat its component exposures as separate services solely because different surgeons performed them.
Is modifier 50 appropriate when the approach is bilateral?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is permitted.
What postoperative care is included in the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
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.
6,82061576,,Skull base/brainstem surgery,A,,53.93,48.90,NA,48.90,,22.75,125.58,125.58,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82161580,,Craniofacial approach skull,A,,33.65,25.75,NA,25.75,,7.02,66.42,66.42,0,090,0.11,0.76,0.13,2,1,1,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82261581,,Craniofacial approach skull,A,,38.15,26.93,NA,26.93,,5.57,70.65,70.65,0,090,0.11,0.76,0.13,2,1,1,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82361582,,Craniofacial approach skull,A,,34.26,44.35,NA,44.35,,13.53,92.14,92.14,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82461583,,Craniofacial approach skull,A,,37.54,34.62,NA,34.62,,15.37,87.53,87.53,0,090,0.11,0.76,0.13,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82561584,,Orbitocranial approach/skull,A,,36.76,33.67,NA,33.67,,14.34,84.77,84.77,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
6,82661585,,Orbitocranial approach/skull,A,,41.51,38.43,NA,38.43,,17.52,97.46,97.46,0,090,0.11,0.76,0.13,2,1,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817