No office rate
Both involve cisternal or suboccipital access, but 61055 is for injecting medication or another substance. Use 61050 for fluid collection or drainage.
On this page
CMS RVU26D · Effective 2026-10-01
61050 Cisternal puncture Medicare reimbursement rates in Virginia
Reports needle access to the cisterna magna to collect or drain cerebrospinal fluid for diagnostic evaluation or therapeutic treatment. Compare 61050 office and facility rates across CMS payment localities in Virginia.
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 61050 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$67.50–$75.05
2 of 2 localities have a 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.
Neurosurgery
About 61050: Cisternal cerebrospinal fluid drainage
Reports needle access to the cisterna magna to collect or drain cerebrospinal fluid for diagnostic evaluation or therapeutic treatment.
This service accesses the cerebrospinal fluid space at the cisterna magna through a suboccipital needle puncture. A neurosurgeon or neurologist typically performs it in a hospital or other procedural setting when fluid must be obtained for testing or drained therapeutically. The approach is distinct from sampling fluid through a lumbar puncture or entering a cerebral ventricle.
Report the service when the documented route is cisternal or suboccipital and the purpose is fluid collection or drainage. The record should identify the indication, access site, procedure performed, and whether fluid was collected or drained. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. This is a single cisternal access, so modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 61050
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.47 · 71%
- Practice expense (office) RVU0.46 · 22%
- Malpractice RVU0.14 · 7%
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.
61050 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
61020 accesses a cerebral ventricle; 61050 accesses the cisterna magna. The documented anatomical route distinguishes them.
$160.19–$188.81
62270 describes diagnostic cerebrospinal fluid collection by lumbar puncture. Use 61050 when the documented route is cisternal or suboccipital.
Compare 61050 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$75.05
Virginia →
Office / nonfacility
Unavailable
Facility
$67.50
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61050 billing questions
How is this different from a lumbar puncture?
This code describes access to the cisterna magna by a suboccipital route. A lumbar puncture accesses cerebrospinal fluid through the lower back.
When should 61055 be reported instead?
Use 61055 when the cisternal puncture is performed to inject medication or another substance. This code is for fluid collection or drainage.
Can modifier 50 be used?
No. The cisternal access is a single-site procedure, and modifier 50 is inappropriate.
What documentation supports reporting this code?
Document the clinical indication, suboccipital or cisternal access route, and whether cerebrospinal fluid was collected or drained.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are 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 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.
6,73761020,,Remove brain cavity fluid,A,,1.47,0.97,NA,0.97,,0.51,2.95,2.95,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,73861026,,Injection into brain canal,A,,1.65,1.01,NA,1.01,,0.48,3.14,3.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,7396102F,,Safety counseling dem order,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74061050,,Remove brain canal fluid,A,,1.47,0.46,NA,0.46,,0.14,2.07,2.07,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74161055,,Injection into brain canal,A,,2.05,0.64,NA,0.64,,0.26,2.95,2.95,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74261070,,Brain canal shunt procedure,A,,0.87,0.52,NA,0.52,,0.15,1.54,1.54,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74361105,,Tdh sdrl/ventr pnxr,A,,5.31,7.38,NA,7.38,,2.23,14.92,14.92,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00