Summary & Overview
CPT 61150: Surgical Drainage of Brain Abscess or Cyst
CPT code 61150 denotes a neurosurgical procedure to create one or more burr holes in the skull for drainage of a brain abscess or cyst. This intervention addresses potentially life-threatening intracranial infections or fluid collections and is performed emergently or urgently when medical therapy alone is insufficient. Nationally, accurate coding of this procedure matters for clinical continuity, appropriate facility resource allocation, and reimbursement for complex neurosurgical care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 61150, common sites of service, and the types of clinical situations that prompt its use. The publication summarizes typical coding considerations, common modifiers encountered in practice (listed in the input), and the expected care setting for billing and utilization purposes.
This report also outlines what to expect in benchmarking and policy review sections: national utilization benchmarks where available, payer policy highlights that commonly affect authorization and coverage for surgical drainage of intracranial abscesses, and notes on documentation elements that support medical necessity. Data not provided in the input—such as specific payer policies, associated taxonomies, and ICD-10 mapping—are identified as unavailable.
Billing Code Overview
CPT code 61150 describes a neurosurgical procedure in which the provider drills one or more holes in the skull to drain a brain abscess or cyst. This procedure is a form of surgical drainage of intracranial abscess or cyst intended to evacuate purulent material or fluid collections that may arise from penetrating head trauma, bacterial or fungal infection, or other intracranial processes.
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Service type: Neurosurgical operative procedure for drainage of intracranial abscess or cyst
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Typical site of service: Hospital operating room or inpatient surgical setting
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old male who presents with fever, focal neurologic deficits, and worsening headache after a recent sinus infection. Neuroimaging (CT or MRI) demonstrates a circumscribed ring-enhancing intracerebral collection consistent with a brain abscess with mass effect and surrounding edema. Neurosurgery is consulted and performs a burr hole drainage procedure (61150) under general anesthesia in an operating room or an interventional suite. Preoperative workflow includes consent, coagulation evaluation, antibiotic administration, and image localization. Intraoperative steps include localization of the collection, creation of a burr hole, aspiration and irrigation of purulent material, placement of a drain if indicated, and closure. Postoperative care includes ICU or step-down monitoring, serial neurologic checks, repeat imaging to document decompression, and targeted antimicrobial therapy guided by culture results. Typical sites of service are the hospital operating room, neurosurgical suite, or occasionally an interventional radiology suite when percutaneous image-guided aspiration is performed under comparable sterile conditions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider billed the usual, customary, and reasonable service | Use for a routine, correctly performed burr hole drainage when payer requires modifier for billing validation |