CPT 61210 Ventricular Drain Reimbursement | OpenPayer

Summary & Overview

CPT 61210: Cranial Access for Ventricular Drainage and Monitoring

Headline: CPT code 61210: Surgical cranial access for ventricular drainage and intracranial monitoring

Lead: CPT code 61210 identifies the neurosurgical procedure in which a surgeon drills one or more holes in the skull to place ventricular drainage catheters, fluid reservoirs, EEG electrodes, or intracranial pressure and monitoring devices. This code captures the creation of access necessary for cerebrospinal fluid drainage and physiologic monitoring of the brain.

CPT code 61210 is nationally significant because it documents a critical access procedure for patients requiring cerebrospinal fluid diversion or invasive intracranial monitoring, often performed in acute, high-acuity settings. Accurate coding of this service affects clinical records, operative reporting, and payment for complex neurosurgical care.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of coding intent, common clinical contexts, and payer coverage considerations for these major national plans.

Readers will learn the clinical purpose of the code, typical sites of service, and the scope of devices and access created under the code. The report also outlines where to find policy guidance and what aspects of documentation are typically relevant for payer review. Data not available in the input for specific coverage policies, associated taxonomies, and ICD-10 pairings is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare61210CPTneurosurgeryventricular-drainageintracranial-monitoringoperative-procedurehospital-surgeryEEG-electrodes

Billing Code Overview

CPT code 61210 describes the surgical creation of one or more cranial openings to place devices that access the intracranial space. The procedure includes drilling holes in the skull to implant ventricular drainage catheters, fluid reservoirs, electroencephalography (EEG) electrodes, or pressure and other monitoring devices.

Service type: Neurosurgical cranial access for catheter or monitoring device placement
Typical site of service: Hospital operating room or inpatient surgical setting; may also be performed in acute care procedural suites where neurosurgical procedures are performed

Clinical & Coding Specifications

Clinical Context

A 62-year-old male is brought to the emergency department after a subarachnoid hemorrhage with declining mental status and evidence of acute hydrocephalus on CT. Neurosurgery is consulted and the patient is taken to the operating room for placement of an external ventricular drain (EVD). Under sterile conditions, the neurosurgeon drills a burr hole in the skull, inserts a ventricular drainage catheter into the lateral ventricle, and connects it to an external drainage system to monitor and control intracranial pressure and drain cerebrospinal fluid. The procedural workflow includes preoperative consent, imaging review (CT/MRI), patient positioning, sterile field preparation, local and/or general anesthesia administration, burr hole creation, catheter placement with cerebrospinal fluid return confirmation, securement of catheter and device (reservoir or drain), documentation of device type and laterality, postoperative imaging to confirm position, and ICU-level monitoring of drainage and intracranial pressure. Typical settings are the operating room or an interventional radiology suite for elective implantations, and the emergency department or bedside in the intensive care unit for emergent bedside placement. This procedure provides intracranial access for ventricular drainage, pressure monitoring, device implantation (reservoir), or placement of depth electrodes for EEG monitoring when indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than usual for , with documentation of reasons and increased work.

CPT 61150: Surgical Drainage of Brain Abscess or Cyst

CPT-61215-IMPLANTABLE-INFUSION-DEVICE-INSERTION-CSF-CHEMOTHERAPY

CPT 61215: Implantable Infusion Device Insertion for CSF or Chemotherapy

CPT-61105-SKULL-DRILL-VENTRICULAR-SUBDURAL-FLUID-DRAINAGE

CPT 61105: Skull Opening for Ventricular or Subdural Fluid Drainage

CPT-61154-NEUROSURGICAL-BURR-HOLE-HEMATOMA-EVACUATION

CPT 61154: Burr-Hole Evacuation of Intracranial Hematoma

CPT-61107-BURR-HOLE-CRANIAL-ACCESS-INTRACRANIAL-DRAINAGE-MONITORING

CPT 61107: Burr-Hole Cranial Access for Intracranial Drainage/Monitoring

CPT-61120-CRANIAL-ACCESS-FOR-DIAGNOSTIC-INTRACRANIAL-INJECTION

CPT 61120: Cranial Access for Diagnostic Intracranial Injection

CPT-61156-BURR-HOLE-ASPIRATION-INTRACRANIAL-CYST-HEMATOMA

CPT 61156: Burr-Hole Aspiration of Intracranial Cyst or Hematoma

CPT-61253-INFRATENTORIAL-BURR-HOLE-INSPECTION

CPT 61253: Infratentorial Burr Hole Brain Inspection

CPT-61140-SKULL-BIOPSY-DRILLING-FOR-TISSUE-SAMPLE

CPT 61140: Skull Biopsy for Diagnostic Tissue Sampling

CPT-61151-BRAIN-ABSCESS-CYST-ASPIRATION-THROUGH-ESTABLISHED-BURR-HOLE

CPT 61151: Aspiration of Brain Abscess or Cyst via Established Burr Hole

Showing 1–10 of 12

61210

Taxonomy Code	Specialty	Notes
207RN0400X	Neurological Surgery	Primary specialty performing intracranial access and ventricular catheter placements.
2084P0800X	Critical Care Medicine	Intensivists involved in ICU monitoring and management post-placement; may place bedside drains in some systems.
207RC0000X	Neurology	Neurologists may be involved for EEG electrode placement and monitoring; less commonly perform the surgical access.
207LH0004X	Emergency Medicine	Emergency physicians may facilitate emergent bedside burr hole/EVD placement in critical scenarios at some institutions.
2084N0400X	Neuroradiology	Interventional neuroradiologists may assist with image-guided catheter placements in select settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I62.0`	Nontraumatic subarachnoid hemorrhage	Common indication for ventricular drainage and intracranial pressure monitoring when hydrocephalus or elevated ICP occurs.
`I61.9`	Intracerebral hemorrhage, unspecified	Hemorrhagic stroke can cause hydrocephalus or elevated ICP requiring ventricular access.
`S06.5X0A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Traumatic intracranial hemorrhage with mass effect may require intracranial drainage or monitoring.
`G91.2`	Reversible hydrocephalus	Direct indication for CSF diversion via external ventricular drain or shunt reservoir placement.
`G94`	Other and unspecified disorders of intracranial system, not elsewhere classified	Used for intracranial pressure monitoring or procedures when specific diagnosis is less defined.
`R40.0`	Somnolence and stupor	Altered mental status prompting intracranial monitoring and possible ventricular drain placement.
`G40.919`	Epilepsy, unspecified, not intractable, without status epilepticus	When depth electrodes or EEG monitoring devices are placed via burr holes for seizure focus localization.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61107`	Cranial puncture for intracranial pressure monitoring, placement of transducers or monitoring device	Alternative code for placement of intracranial pressure monitor; may be used for transducer placement distinct from burr hole access when coding specifics differ.
`61220`	Craniectomy or craniotomy for evacuation of hematoma or drainage of abscess	Performed when simultaneous evacuation of hemorrhage or abscess is required at time of ventricular access.
`62160`	Ventriculostomy for drainage and/or sampling of CSF (external ventricular shunt)	Related drainage procedure; used when coding the therapeutic drainage or sampling beyond initial burr hole access.
`61790`	Stereotactic implantation of intracranial neurostimulator electrode array	Related when depth electrodes or intracranial electrode arrays are placed through burr holes for monitoring or stimulation.
`61254`	Implantation of programmable ventricular shunt valve, including placement of reservoir	May be performed in same episode for permanent CSF diversion following external drain placement and assessment.

OpenPayer