Billing code 61605: Skull-base resectionMedicare rate & RVUs in Virginia
Reports surgical removal of a lesion in the extradural space of the middle cranial fossa, with dural repair included when performed.
CMS doesn’t publish an office rate for 61605 in Virginia.
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 61605 covers
This service covers surgical resection or excision of a neoplastic, vascular, or infectious lesion in the middle cranial fossa when the operative work is extradural. A neurosurgeon, often working with a skull-base team, performs the procedure in an operating room. The operative report should identify the lesion’s location and document that the work was extradural; the diagnosis alone does not establish the anatomic site or surgical plane. Dural repair, with or without a graft, is part of the service.
Select this code for the middle cranial fossa extradural location, rather than a different cranial fossa or an intradural procedure. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 61605 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $2,109.33 |
| Virginia | Unavailable | $1,846.52 |
How the 61605 rate is calculated
Each of 61605’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 · 61605
RVUs × geographic indexes × conversion factor
Work31.76
31.76 RVUs× 1.000 GPCI
Practice expense19.93
19.93 RVUs× 1.000 GPCI
Malpractice5.57
5.57 RVUs× 1.000 GPCI
Adjusted RVUs
57.2600
Conversion factor
$33.4009
Medicare rate
$1,912.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61605
61605 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61605
Skull-base resection
| 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) | 2 | 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 · 61605
Skull-base resection
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
61605 without 51 · national facility
$1,912.54
Skull-base resection
61605-51 · Second procedure: 50%
$956.27
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%).
61605 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61606Skull-base lesion resection
- Use 61605 for extradural resection in the middle cranial fossa; use 61606 when the lesion is treated intradurally in that fossa.
- 61600Skull base resection
- This code is for the middle cranial fossa. Code 61600 is the corresponding extradural lesion-resection service for the anterior cranial fossa.
- 61607Cranial lesion resection
- Both describe extradural lesion resection, but 61607 is for the posterior cranial fossa rather than the middle cranial fossa.
61605 billing questions
How does this differ from code 61606?
Both concern a middle cranial fossa lesion, but 61605 is for extradural operative work and 61606 is for intradural work. The operative report should support the compartment treated.
Is dural repair separately reported?
Dural repair, with or without a graft, is included in this lesion-resection service. The operative note should document the repair as part of the procedure.
What documentation supports this code?
Document the lesion’s middle cranial fossa location, its pathology when known, and the extradural surgical plane. Describe the resection and any dural repair performed.
How does the multiple-procedure reduction work?
For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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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