Billing code 61253: Burr-hole procedureMedicare rate & RVUs in Washington
Reports burr-hole or trephine evacuation or drainage of an extradural or subdural hematoma, whether the procedure is unilateral or bilateral.
CMS doesn’t publish an office rate for 61253 in Washington.
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 61253 covers
A neurosurgeon uses a burr hole or trephine opening to reach and evacuate or drain an extradural or subdural hematoma. A familiar clinical setting is surgical drainage of a chronic subdural hematoma. The code identifies this limited cranial approach, rather than an open craniotomy for hematoma evacuation. It may describe treatment on one or both sides.
Report the service when the operative documentation supports evacuation or drainage of an extradural or subdural hematoma through the specified burr-hole or trephine approach. Record the hematoma compartment, operative approach, and treated side or sides. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. The code is priced as bilateral, so modifier 50 does not increase payment. An assistant at surgery may be paid; co-surgeons and team surgery are not 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 61253 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $979.66 |
| Seattle (King Cnty) | Unavailable | $1,071.37 |
How the 61253 rate is calculated
Each of 61253’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 · 61253
RVUs × geographic indexes × conversion factor
Work13.15
13.15 RVUs× 1.000 GPCI
Practice expense11.20
11.20 RVUs× 1.000 GPCI
Malpractice5.54
5.54 RVUs× 1.000 GPCI
Adjusted RVUs
29.8900
Conversion factor
$33.4009
Medicare rate
$998.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61253
61253 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61253
Burr-hole procedure
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not 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 · 61253
Burr-hole procedure
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
61253 without 51 · national facility
$998.35
Burr-hole procedure
61253-51 · Second procedure: 50%
$499.18
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%).
61253 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61312Hematoma evacuation
- This code describes burr-hole or trephine treatment of an extradural or subdural hematoma. Code 61312 is for open evacuation of a supratentorial hematoma.
- 61156Burr-hole aspiration
- This code applies to extradural or subdural hematoma treatment through a burr hole or trephine; 61156 concerns evacuation or drainage of an intracerebral hematoma.
- 61250Brain exploration
- Choose 61250 for burr-hole or trephine exploration or drainage of an intracranial abscess or cyst, not for extradural or subdural hematoma.
61253 billing questions
When is this code preferable to an open craniotomy code?
Use this code when the documented hematoma evacuation or drainage is performed through a burr hole or trephine. An open craniotomy for hematoma evacuation is a different operative approach.
Should modifier 50 be appended for bilateral treatment?
The code is already priced as bilateral, and modifier 50 does not increase payment. Document the side or sides treated in the operative report.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this procedure?
CMS permits assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.
How are other procedures performed in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction.
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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