Summary & Overview
CPT 61107: Burr-Hole Cranial Access for Intracranial Drainage/Monitoring
CPT code 61107 denotes a burr-hole cranial access procedure using a hand-operated twist drill to reach intracerebral spaces, subdural/subarachnoid regions below the dura, or the ventricular system. It is commonly performed to remove intracranial fluid, place drainage catheters, or implant pressure-monitoring devices and is a critical intervention in acute neurosurgical care. Nationally, this code represents an essential, time-sensitive service tied to emergency and inpatient neurosurgical workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content outlines the clinical context and common sites of service and is relevant to hospital billing departments, neurosurgeons, and health plan policy teams.
Readers will find a concise explanation of what the code represents, how it is used clinically, and what to expect in billing practice. The publication provides benchmarks where available, notes of common modifiers and associated administrative considerations, and summarizes the clinical scenarios that typically generate use of the code. Data not available in the input is noted explicitly where applicable.
Billing Code Overview
CPT code 61107 describes a neurosurgical procedure in which a hand-operated twist drill is used to create one or more small openings in the skull to access the intracerebral space, the area beneath the dura, or the ventricular system. The procedure is performed to insert a needle for fluid removal, to place a drainage catheter, or to implant a pressure or other monitoring device to measure intracranial pressure.
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Service type: Neurosurgical cranial access for intracranial fluid management and monitoring
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Typical site of service: Operating room or procedure suite in an acute care hospital setting, including inpatient and emergency department contexts where intracranial access and monitoring are required.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents to the emergency department with acute neurologic decline after a motor vehicle collision. He is somnolent, with unequal pupils and suspected increased intracranial pressure. Head CT demonstrates a focal intracerebral hemorrhage with mass effect and midline shift and suspected elevated intracranial pressure. The neurosurgeon performs a bedside burr hole procedure using a hand-operated twist drill to access the intracerebral space and ventricles to place an external ventricular drain for cerebrospinal fluid diversion and intracranial pressure monitoring. The workflow includes pre-procedure consent, sterile field preparation, local anesthesia or monitored anesthesia care, twist-drill craniostomy creation, catheter insertion and securement, intracranial pressure transducer placement or external ventricular drain connection, documentation of laterality and technique, post-procedure head CT and neurocritical care monitoring. Typical sites of service are the emergency department, operating room, or intensive care unit. The service type is a neurosurgical invasive diagnostic/therapeutic procedure for intracranial access and monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When only the physician professional component is billed and technical component is billed by another entity or hospital |