No office rate
Choose 61304 for exploration above the tentorium and 61305 for exploration below it, in the infratentorial region.
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CMS RVU26D · Effective 2026-10-01
61304 Exploratory craniotomy Medicare reimbursement rates in Virginia
Reports an exploratory cranial opening above the tentorium when the surgeon investigates intracranial pathology without performing a separately defined therapeutic procedure. Compare 61304 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 61304 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
$1506.36–$1780.11
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 61304: Supratentorial exploratory craniotomy
Reports an exploratory cranial opening above the tentorium when the surgeon investigates intracranial pathology without performing a separately defined therapeutic procedure.
A neurosurgeon opens the skull over the cerebral hemispheres, above the tentorium, to inspect intracranial structures when exploration is the operative objective. The surgeon may create a temporary bone opening or remove bone as part of the approach. This is a facility-based cranial operation, typically performed in an operating room; Medicare recorded facility services for this code in 2024.
Select the code based on the supratentorial location and the exploratory purpose documented in the operative report. Record the approach, structures examined, findings, and any additional procedure performed so the reported service reflects the work actually done. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this cranial service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 61304
- 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 not permitted.
Where the value comes from
- Work RVU22.82 · 47%
- Practice expense (office) RVU15.82 · 33%
- Malpractice RVU9.53 · 20%
397
Medicare services in 2024 · #3744 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.
61304 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
61312 identifies evacuation of a supratentorial extradural or subdural hematoma; 61304 describes exploration rather than that specified treatment.
No office rate
61313 is for evacuation of an intracerebral hematoma. Use 61304 when the documented operation is exploratory rather than hematoma evacuation.
Compare 61304 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
$1780.11
Virginia →
Office / nonfacility
Unavailable
Facility
$1506.36
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61304 billing questions
How is this code distinguished from 61305?
This code describes exploration above the tentorium, over the cerebral hemispheres. Code 61305 is for exploration below the tentorium in the infratentorial region.
Should this code be used when the surgeon evacuates a hematoma?
Choose a hematoma-specific code when evacuation is the procedure performed. For a supratentorial extradural or subdural hematoma, compare 61312; for an intracerebral hematoma, compare 61313.
What should the operative report establish?
Document the supratentorial operative location, the exploratory purpose, the approach, and the structures examined. Describe any therapeutic procedure performed so code selection reflects the actual operation.
Can modifier 50 be appended?
No. Modifier 50 is not appropriate for this cranial exploration; report the service once rather than as a bilateral procedure.
How are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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.
6,75461215,,Ins subq rsvr pmp/nfs sys,A,,5.70,8.59,NA,8.59,,2.40,16.69,16.69,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75561250,,Burr hole/treph sttl expl,A,,11.20,10.51,NA,10.51,,4.73,26.44,26.44,0,090,0.11,0.76,0.13,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75661253,,Burr hole treph ittl uni/bi,A,,13.15,11.20,NA,11.20,,5.54,29.89,29.89,0,090,0.11,0.76,0.13,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75761304,,Crnec/crnot expl supratntorl,A,,22.82,15.82,NA,15.82,,9.53,48.17,48.17,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75861305,,Crnec/crnot expl infratntorl,A,,27.92,18.95,NA,18.95,,11.81,58.68,58.68,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75961312,,Crnec/crnot sttl xdrl/sdrl,A,,29.42,18.25,NA,18.25,,12.36,60.03,60.03,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,76061313,,Crnec/crnot sttl icere,A,,27.39,19.42,NA,19.42,,11.50,58.31,58.31,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00