CPT 61606
Global 090 ActiveResect/excise cranial lesion
CPT 61606 Billing & Documentation Guide
CPT code 61606 (Resect/excise cranial lesion) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 41, a non-facility practice expense RVU of 26.61, and a malpractice RVU of 14.07, a total non-facility RVU of 81.68 and facility RVU of 81.68. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2727.24, though rates vary from $2365.65 to $3483.18 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61606, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 61606 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 61606 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 61606
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 41 | 41 |
| Practice Expense RVU | 26.61 | 26.61 |
| Malpractice RVU | 14.07 | 14.07 |
| Total RVU | 81.68 | 81.68 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61606
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $2725.07 | $2725.07 | $2618.73 - $3053.62 | 29 |
| Florida | $3176.03 | $3176.03 | $2925.46 - $3483.18 | 3 |
| Georgia | $2781.7 | $2781.7 | $2722.43 - $2840.97 | 2 |
| Illinois | $3131.11 | $3131.11 | $2915.44 - $3350.8 | 4 |
| Michigan | $2865.47 | $2865.47 | $2711.48 - $3019.46 | 2 |
| North Carolina | $2498.98 | $2498.98 | $2498.98 - $2498.98 | 1 |
| New York | $3064.84 | $3064.84 | $2544.17 - $3386.56 | 5 |
| Ohio | $2654.62 | $2654.62 | $2654.62 - $2654.62 | 1 |
| Pennsylvania | $2754.72 | $2754.72 | $2629.46 - $2879.98 | 2 |
| Texas | $2688.52 | $2688.52 | $2614.83 - $2909.62 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 61606
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61606 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 61606
What does CPT code 61606 mean? +
CPT code 61606 represents: Resect/excise cranial lesion. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 61606? +
The 2026 Medicare national average non-facility payment for CPT 61606 is $2727.24. Rates range from $2365.65 to $3483.18 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61606? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 61606? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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