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Official Description

Craniectomy; with excision of tumor or other bone lesion of skull

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 61500 refers to a craniectomy that involves the excision of a tumor or other bone lesion located in the skull. This surgical intervention is necessary when tumors or lesions arise from various tissues, including bone, cartilage, blood vessels, or neuroepithelial cells, and can also include metastatic lesions that have spread from other parts of the body. During the procedure, a surgical incision is made in the skin, which is then extended through the soft tissue that covers the area of the tumor or lesion. The surgeon carefully incises and elevates the periosteum, which is the dense layer of vascular connective tissue enveloping the bones. The tumor or lesion is excised along with a margin of healthy tissue to ensure complete removal and minimize the risk of recurrence. If the periosteum is found to be healthy after the excision, it is closed over the resulting defect. However, if the periosteum is compromised and requires excision, the defect may be filled with materials such as bone wax or silicone to promote healing. Finally, the fascia and muscle layers are closed over the defect, and the scalp is sutured in a layered manner to ensure proper healing and cosmetic appearance.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 61500 is indicated for the excision of tumors or other bone lesions of the skull. The following conditions may warrant this surgical intervention:

  • Skull Tumors Tumors that originate in the bone, cartilage, or connective tissues of the skull.
  • Metastatic Lesions Lesions that have spread to the skull from other primary cancer sites.
  • Bone Lesions Abnormal growths or lesions affecting the bone structure of the skull.

2. Procedure

The procedure for CPT® Code 61500 involves several critical steps to ensure the effective removal of the tumor or bone lesion:

  • Step 1: Incision A surgical incision is made in the skin over the area of the tumor or lesion. This incision is carefully planned to provide adequate access while minimizing damage to surrounding tissues.
  • Step 2: Soft Tissue Dissection The incision is extended through the soft tissue layers that cover the skull, allowing the surgeon to reach the periosteum, which is the protective layer surrounding the bone.
  • Step 3: Periosteum Elevation The periosteum is incised and elevated to expose the underlying bone and the tumor or lesion. This step is crucial for accessing the lesion while preserving as much healthy tissue as possible.
  • Step 4: Excision of Tumor or Lesion The tumor or bone lesion is excised along with a margin of healthy tissue. This ensures complete removal and reduces the likelihood of recurrence.
  • Step 5: Closure of Periosteum If the periosteum is healthy, it is closed over the defect created by the excision. If the periosteum is unhealthy and must be removed, the defect may be filled with bone wax or silicone to aid in healing.
  • Step 6: Closure of Soft Tissue The fascia and muscle layers are then closed over the defect, followed by the closure of the scalp in a layered fashion to promote optimal healing and cosmetic results.

3. Post-Procedure

After the completion of the craniectomy and excision of the tumor or bone lesion, post-procedure care is essential for recovery. Patients are typically monitored for any signs of complications, such as infection or excessive bleeding. Pain management is provided as needed, and instructions for wound care are given to ensure proper healing. Follow-up appointments are scheduled to assess recovery and to monitor for any recurrence of the lesion. The expected recovery time may vary depending on the extent of the surgery and the patient's overall health.

Short Descr CRNEC EXC TUM/BONE LES SKULL
Medium Descr CRANIECTOMY W/EXCISION TUMOR/OTH BONE LESION SKL
Long Descr Craniectomy; with excision of tumor or other bone lesion of skull
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 9 - Other OR therapeutic nervous system procedures

This is a primary code that can be used with these additional add-on codes.

69990 Addon Code MPFS Status: Restricted APC N ASC N1 PUB 100 CPT Assistant Article 1Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)
GC This service has been performed in part by a resident under the direction of a teaching physician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
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2025-01-01 Changed Short and Medium Descriptions changed.
Pre-1990 Added Code added.
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