Summary & Overview
CPT 61108: Cranial Hematoma Evacuation (Burr Holes)
CPT code 61108 denotes a neurosurgical procedure to create one or more skull openings (burr holes) to evacuate a surface hematoma and relieve intracranial pressure. The procedure is clinically significant nationwide because it addresses life-threatening intracranial hemorrhage from trauma or iatrogenic causes and often determines short-term neurologic outcomes. It is typically performed emergently in inpatient settings such as operating rooms, emergency departments, or intensive care units.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical intent and typical settings for the service, a summary of common billing and coding considerations, and an overview of payer coverage patterns and benchmark context where available. The publication highlights relevant procedural context, common modifiers in use, and areas where policy or prior authorization rules commonly affect access and reimbursement. Where payer-specific policy language is not provided, the report notes that data were not available in the input. The goal is to give clinicians, coding professionals, and policy analysts a clear, national-level primer on the clinical service represented by CPT code 61108 and the typical billing environment surrounding emergency cranial hematoma evacuation.
Billing Code Overview
CPT code 61108 describes a neurosurgical procedure in which the provider drills one or more openings in the skull to evacuate a hematoma and relieve intracranial pressure. This procedure is performed to remove blood collections on the surface of the brain that result from trauma or as a complication of other medical interventions.
-
Service type: Emergent neurosurgical hematoma evacuation/cranial decompression
-
Typical site of service: Inpatient hospital setting, commonly performed in operating rooms, emergency departments, or intensive care units depending on clinical urgency and patient stability.
Data not available in the input for payers, associated taxonomies, and ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents to the emergency department after head trauma with progressive headache, decreased level of consciousness, focal neurologic deficits, or rapidly expanding scalp hematoma. Neuroimaging (noncontrast CT head) demonstrates an acute extra-axial collection producing mass effect, midline shift, or clinical deterioration consistent with an acute subdural or epidural hematoma. Neurosurgery evaluates the patient, obtains consent from the patient or surrogate for an emergent surgical evacuation, and coordinates activation of the operating room or performs at bedside if warranted. The provider prepares the patient with airway and hemodynamic stabilization, administers perioperative antibiotics and analgesia, and marks the operative site. Under general anesthesia (or monitored anesthesia care when appropriate), the neurosurgeon performs a burr hole or multiple burr holes in the skull to evacuate the hematoma, control bleeding, irrigate the subdural/epidural space, and may place a drain. Postprocedure care includes ICU-level neurologic monitoring, repeat CT imaging to confirm decompression, and documentation of estimated blood loss, complications, and postoperative neurologic status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Anesthesia: General/Regional/Monitored Anesthesia Care (MAC) not otherwise specified | Rarely used; some systems list for anesthesia reporting when no modifier specified for professional claims |