Summary & Overview
CPT 61518: Craniectomy for Infratentorial/Posterior Fossa Brain Tumor Excision
CPT 61518 denotes a neurosurgical craniectomy performed to excise infratentorial or posterior fossa brain tumors, excluding meningiomas, cerebellopontine angle tumors, and midline skull-base lesions. Nationally, this code captures high-acuity operative management of posterior fossa neoplasms where surgical access via skull removal is required. It matters because it reflects complex operative work, resource-intensive perioperative care, and potential implications for hospital and surgeon billing across payers.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical context of the procedure, guidance on typical sites of service, and mention of common billing modifiers and related CPTs for situational coding clarity. The publication highlights coding boundaries (which tumor types are excluded under this descriptor), common ICD-10 diagnoses that may support use of the code, and adjacent codes that clinicians and coders may need to consider when selecting the appropriate operative code.
This summary serves clinicians, coding professionals, and payers seeking a clear, national-level reference on what CPT 61518 represents, where it is typically performed, and what coding considerations and related codes are commonly associated with infratentorial/posterior fossa tumor excision.
CPT Code Overview
CPT 61518 describes a craniectomy for excision of a brain tumor located in the infratentorial or posterior fossa, excluding procedures for meningioma, cerebellopontine angle tumors, or midline tumors at the base of the skull. The procedure is performed by neurosurgeons and involves removal of part of the skull to access and excise the specified intracranial tumor.
Service type: Neurosurgery
Typical site of service: Hospital inpatient or outpatient surgical setting (for example, POS 21 or 22)
Clinical & Coding Specifications
Clinical Context
A patient presents with symptoms such as progressive headache, cerebellar ataxia, cranial nerve deficits, or new focal neurologic signs consistent with a posterior fossa or infratentorial mass. Imaging (MRI with contrast) demonstrates an infratentorial/posterior fossa intra-axial lesion suspicious for primary or metastatic neoplasm or a compressive lesion producing brainstem or cerebellar compression. Neurosurgery evaluates the patient and schedules a craniectomy for resection of the tumor via a posterior fossa approach. The procedure typically occurs in a hospital inpatient or outpatient surgical setting, with preoperative consent, intraoperative neuromonitoring as indicated, general endotracheal anesthesia, and postoperative admission for neurologic observation and imaging. Pathology specimens are sent for histologic diagnosis and postoperative care includes monitoring for increased intracranial pressure, cranial nerve function, and rehabilitation needs.
Coding Specifications
Modifier 62 - Two Surgeons
- Use when two surgeons with distinct responsibilities perform portions of the same operative session, each contributing specialized skills.
Modifier 80 - Assistant Surgeon
- Use when an assistant surgeon is documented as providing surgical assistance during the procedure.
Provider Taxonomies
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