No office rate
Choose 61055 when a substance is injected through cisternal access. Choose 61050 for cisternal puncture performed for aspiration or another diagnostic or therapeutic purpose.
On this page
CMS RVU26D · Effective 2026-10-01
61055 Cisternal injection Medicare reimbursement rates in Washington
A cisternal puncture with injection into the cerebrospinal-fluid space at the brain base, reported when medication or another substance is delivered by this route. Compare 61055 office and facility rates across CMS payment localities in Washington.
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 61055 in Washington?
Washington 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
$98.48–$105.22
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.
Neurosurgical procedure
About 61055: Cisternal puncture with injection
A cisternal puncture with injection into the cerebrospinal-fluid space at the brain base, reported when medication or another substance is delivered by this route.
This service accesses the cisterna magna, a cerebrospinal-fluid space at the base of the brain, and injects medication, contrast, or another substance. A neurosurgeon, neurologist, or other qualified physician may perform it in a hospital or other procedural setting when the clinical plan calls for delivery through this cisternal route. It is distinct from injecting into a cerebral ventricle or accessing an existing shunt reservoir.
Report 61055 for the cisternal injection procedure; the puncture needed to reach the space is part of that service. Documentation should identify the cisternal access, the substance injected, and the clinical purpose. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 61055
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.05 · 69%
- Practice expense (office) RVU0.64 · 22%
- Malpractice RVU0.26 · 9%
109
Medicare services in 2024 · #4817 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.
61055 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
61026 describes injection through a ventricular puncture. 61055 is for injection through the cisterna magna.
No office rate
61070 accesses shunt tubing or a reservoir; 61055 uses a cisternal puncture to deliver the injection.
Compare 61055 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$98.48
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$105.22
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61055 billing questions
How is 61055 different from 61050?
61055 is for injecting a substance through cisternal access. 61050 describes cisternal puncture for aspiration or other diagnostic or therapeutic purposes.
Can the puncture be billed separately from the injection?
No. The access required to deliver the injection is included in the cisternal injection service.
Should modifier 50 be used for bilateral treatment?
No. Modifier 50 is inappropriate for this code because the descriptor and anatomy do not support bilateral adjustment.
Is an assistant surgeon payable for 61055?
No. Medicare's statutory restriction bars payment for an assistant at surgery for this service. Co-surgeon and team-surgery billing are also not permitted.
What documentation supports reporting 61055?
Document that access was through the cisterna magna, identify the injected substance, and state the clinical purpose. The record should distinguish cisternal access from ventricular or shunt-reservoir access.
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.
6,73861026,,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
6,74461107,,Tdh pnxr implt ventr cath,A,,4.87,1.70,NA,1.70,,2.04,8.61,8.61,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00