CPT 61607
Global 090 ActiveResect/excise cranial lesion
CPT 61607 Billing & Documentation Guide
CPT code 61607 (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 39.91, a non-facility practice expense RVU of 23.47, and a malpractice RVU of 11.26, a total non-facility RVU of 74.64 and facility RVU of 74.64. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2500.31, though rates vary from $2198.75 to $3100.23 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61607, 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 61607 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 61607 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 61607
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 39.91 | 39.91 |
| Practice Expense RVU | 23.47 | 23.47 |
| Malpractice RVU | 11.26 | 11.26 |
| Total RVU | 74.64 | 74.64 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61607
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 | $2512.35 | $2512.35 | $2416.45 - $2811.66 | 29 |
| Florida | $2851.69 | $2851.69 | $2647.73 - $3100.23 | 3 |
| Georgia | $2532.89 | $2532.89 | $2480.59 - $2585.18 | 2 |
| Illinois | $2813.87 | $2813.87 | $2636.58 - $2993.34 | 4 |
| Michigan | $2598.49 | $2598.49 | $2473.36 - $2723.61 | 2 |
| North Carolina | $2304.75 | $2304.75 | $2304.75 - $2304.75 | 1 |
| New York | $2782.09 | $2782.09 | $2342.15 - $3048.83 | 5 |
| Ohio | $2427.85 | $2427.85 | $2427.85 - $2427.85 | 1 |
| Pennsylvania | $2514.92 | $2514.92 | $2408.08 - $2621.76 | 2 |
| Texas | $2461.47 | $2461.47 | $2395.79 - $2639.63 | 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 61607
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61607 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 61607
What does CPT code 61607 mean? +
CPT code 61607 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 61607? +
The 2026 Medicare national average non-facility payment for CPT 61607 is $2500.31. Rates range from $2198.75 to $3100.23 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61607? +
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 61607? +
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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