Find policies, billing codes, payers, states, and providers

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

CPT code 61304 refers to a neurosurgical procedure to inspect the anterior portion of the brain via cranial access above the tentorium. This code is used when other diagnostic modalities are unable to determine the cause, location, or extent of intracranial pathology, including lesions or tumors. Nationally, use of this code reflects cases requiring direct surgical visualization for diagnosis or assessment and has implications for surgical resource utilization and inpatient surgical workflows.

Key payers discussed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for when direct supratentorial inspection is indicated, typical sites of service, and common billing considerations. The publication also covers benchmarking where available, coding guidance highlights, and any recent policy updates or payer-level coverage notes that affect claim adjudication and documentation requirements.

The content provides clinicians, coders, and policy analysts with a concise reference to the clinical purpose of CPT code 61304, payer coverage landscape, and the operational context in which the code is billed. Data not available in the input are noted where applicable.

Customize your policy alerts

Sign up for cpt 61304 policy alerts

Get alerted when payer policies referencing 61304 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 61304 describes a neurosurgical procedure in which the surgeon inspects the anterior (front) region of the brain by accessing the cranial cavity above the tentorium. This procedure is typically undertaken when noninvasive diagnostic testing cannot determine the cause of a neurologic condition, identify the precise location of a lesion or tumor, or assess the extent of intracranial damage.

Service type: Open neurosurgical diagnostic/operative inspection of the anterior cranial compartment
Typical site of service: Inpatient or outpatient hospital operating room where neurosurgical access to the supratentorial (above the tentorium) brain is performed

Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and service line.

Explore openpayer tools

View all tools

Find policies, billing codes, payers, states, and providers

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

Customize your policy alerts

Sign up for cpt 61304 policy alerts

Get alerted when payer policies referencing 61304 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Open neurosurgical diagnostic/operative inspection of the anterior cranial compartment
Typical site of service: Inpatient or outpatient hospital operating room where neurosurgical access to the supratentorial (above the tentorium) brain is performed

Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, and service line.

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient presents with progressive headaches, focal neurologic deficits, and an indeterminate intracranial mass on MRI. Noninvasive imaging (MRI with and without contrast, MR spectroscopy, CT) has been unable to definitively characterize the lesion or provide a safe biopsy corridor. The neurosurgical team elects a frontal craniotomy above the tentorium to directly inspect the anterior cranial fossa and frontal lobes, obtain targeted tissue for diagnosis, and assess tumor extent and resectability.

The typical workflow includes preoperative imaging review, multidisciplinary tumor board discussion, informed consent for craniotomy and possible resection, general anesthesia, scalp incision and skull flap creation, dural opening and inspection of the anterior cranial compartment, targeted biopsy or partial resection as indicated, hemostasis, closure of dura and skull, and postoperative neurosurgical ICU monitoring with follow-up imaging and pathology-directed management.

Coding Specifications

Modifier	Description	When to Use
`11`	Physician or other qualified health care professional service by the reporting provider	Use when the service is performed as billed by the primary surgeon without unusual circumstances.
`22`	Increased procedural services	Use when work required is substantially greater than typically required (e.g., extensive adhesions, difficult exposure).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but halted due to patient instability or intraoperative findings requiring stop.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons for this cranial procedure.
`63`	Procedure performed on infants less than 4 kg	Use when patient meets weight criteria for the modifier (pediatric application when applicable).
`66`	Surgical team (multiple surgeons)	Use when multiple surgeons participate as a team for complex cranial surgery.
`78`	Unplanned return to the operating room following initial procedure	Use when the patient requires an unplanned reoperation for a related complication during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon performs a portion of the procedure.
`81`	Minimum assistant surgeon	Use when a minimal assistant role is documented.
`82`	Assistant surgeon (when qualified resident surgeon not available)	Use when a non-resident assistant is required and documentation supports it.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP serves in an assistant role and payer allows APP assistant reporting.
`22`	Increased procedural services	See above; relevant for extensive operative time or complexity.

Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing craniotomy/brain inspection and resection.
207RC0000X	Neurology	Often involved preoperatively and postoperatively for neurologic assessment; not the operating specialty.
363L00000X	Anesthesiology	Provides general anesthesia and intraoperative physiologic management; critical for cranial cases.
207K00000X	Radiology	Preoperative and intraoperative imaging guidance (e.g., neuronavigation, intraoperative CT/MRI).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C71.9`	Malignant neoplasm of brain, unspecified	Common indication when imaging suggests a primary brain tumor requiring direct inspection and biopsy.
`D43.2`	Neoplasm of uncertain behavior of brain, supratentorial	Used when imaging cannot determine malignant potential and tissue diagnosis is needed.
`G93.6`	Cerebral edema, not elsewhere classified	May be present with mass lesions and necessitate surgical decompression combined with inspection.
`I62.9`	Nontraumatic intracranial hemorrhage, unspecified	When hemorrhagic lesions or cavernous malformations are suspected and direct inspection or evacuation is required.
`G40.9`	Epilepsy, unspecified	Focal epileptogenic lesions resistant to medical therapy may prompt an inspection and lesionectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61582`	Craniectomy or craniotomy for excision or removal of brain tumor, supratentorial, except meningioma, total or partial	Performed when the inspection leads to tumor resection; represents definitive tumor excision often following inspection.
`61510`	Craniectomy or craniotomy for lesionectomy, supratentorial; for cortical or subcortical lesion	May be used when a cortical lesion is localized and resected during the same operative session after inspection.
`61512`	Craniectomy or craniotomy for lesionectomy, deep-seated lesion	Used when inspection identifies a deep lesion requiring targeted lesionectomy guided by neuronavigation.
`61616`	Stereotactic guidance, intracranial	May be used in conjunction for intraoperative stereotactic localization to target biopsy or resection after frontal inspection.
`61790`	Stereotactic computer-assisted (including image-guidance) procedure during cranial surgery	Used for image-guided navigation during inspection and biopsy to increase accuracy and safety.

CPT 61305: Inspection of Posterior Fossa via Subtentorial Approach

CPT-61312-SUPRATENTORIAL-HEMATOMA-EVACUATION-CRANIOTOMY

CPT 61312: Supratentorial Intracranial Hematoma Evacuation

CPT-61313-FRONTAL-HEMATOMA-EVACUATION-BURR-HOLE-CRANIOTOMY

CPT 61313: Frontal Hematoma Evacuation via Burr Holes

CPT-61314-NEUROSURGICAL-HEMATOMA-EVACUATION-BURR-HOLES

CPT 61314: Neurosurgical Hematoma Evacuation, Burr Holes

CPT-61315-POSTERIOR-FOSSA-CRANIOTOMY-HEMATOMA-EVACUATION

CPT 61315: Posterior Fossa Craniotomy for Cerebellar Hematoma Evacuation

CPT-61316-CRANIAL-BONE-GRAFT-POCKETING-TEMPORARY-ABDOMINAL-STORAGE

CPT 61316: Temporary Subcutaneous Cranial Bone Graft Pocketing

CPT-61320-INTRACRANIAL-ABSCESS-DRAINAGE-SUPRATENTORIAL

CPT 61320: Supratentorial Intracranial Abscess Drainage

CPT-61321-CRANIAL-ABSCESS-DRAINAGE

CPT 61321: Cranial Drainage of Brain Abscess

CPT-61322-DECOMPRESSIVE-CRANIECTOMY-DURAPLASTY

CPT 61322: Decompressive Craniectomy with Possible Duraplasty

CPT-61323-DECOMPRESSIVE-CRANIECTOMY-PARTIAL-BRAIN-RESECTION-DURAPLASTY

CPT 61323: Decompressive Craniectomy with Partial Brain Resection and Duraplasty

Showing 1–10 of 62

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Physician or other qualified health care professional service by the reporting provider	Use when the service is performed as billed by the primary surgeon without unusual circumstances.
`22`	Increased procedural services	Use when work required is substantially greater than typically required (e.g., extensive adhesions, difficult exposure).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but halted due to patient instability or intraoperative findings requiring stop.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons for this cranial procedure.
`63`	Procedure performed on infants less than 4 kg	Use when patient meets weight criteria for the modifier (pediatric application when applicable).
`66`	Surgical team (multiple surgeons)	Use when multiple surgeons participate as a team for complex cranial surgery.
`78`	Unplanned return to the operating room following initial procedure	Use when the patient requires an unplanned reoperation for a related complication during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon performs a portion of the procedure.
`81`	Minimum assistant surgeon	Use when a minimal assistant role is documented.
`82`	Assistant surgeon (when qualified resident surgeon not available)	Use when a non-resident assistant is required and documentation supports it.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an APP serves in an assistant role and payer allows APP assistant reporting.
`22`	Increased procedural services	See above; relevant for extensive operative time or complexity.

Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing craniotomy/brain inspection and resection.
207RC0000X	Neurology	Often involved preoperatively and postoperatively for neurologic assessment; not the operating specialty.
363L00000X	Anesthesiology	Provides general anesthesia and intraoperative physiologic management; critical for cranial cases.
207K00000X	Radiology	Preoperative and intraoperative imaging guidance (e.g., neuronavigation, intraoperative CT/MRI).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C71.9`	Malignant neoplasm of brain, unspecified	Common indication when imaging suggests a primary brain tumor requiring direct inspection and biopsy.
`D43.2`	Neoplasm of uncertain behavior of brain, supratentorial	Used when imaging cannot determine malignant potential and tissue diagnosis is needed.
`G93.6`	Cerebral edema, not elsewhere classified	May be present with mass lesions and necessitate surgical decompression combined with inspection.
`I62.9`	Nontraumatic intracranial hemorrhage, unspecified	When hemorrhagic lesions or cavernous malformations are suspected and direct inspection or evacuation is required.
`G40.9`	Epilepsy, unspecified	Focal epileptogenic lesions resistant to medical therapy may prompt an inspection and lesionectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61582`	Craniectomy or craniotomy for excision or removal of brain tumor, supratentorial, except meningioma, total or partial	Performed when the inspection leads to tumor resection; represents definitive tumor excision often following inspection.
`61510`	Craniectomy or craniotomy for lesionectomy, supratentorial; for cortical or subcortical lesion	May be used when a cortical lesion is localized and resected during the same operative session after inspection.
`61512`	Craniectomy or craniotomy for lesionectomy, deep-seated lesion	Used when inspection identifies a deep lesion requiring targeted lesionectomy guided by neuronavigation.
`61616`	Stereotactic guidance, intracranial	May be used in conjunction for intraoperative stereotactic localization to target biopsy or resection after frontal inspection.
`61790`	Stereotactic computer-assisted (including image-guidance) procedure during cranial surgery	Used for image-guided navigation during inspection and biopsy to increase accuracy and safety.

CPT 61305: Inspection of Posterior Fossa via Subtentorial Approach

CPT-61312-SUPRATENTORIAL-HEMATOMA-EVACUATION-CRANIOTOMY

CPT 61312: Supratentorial Intracranial Hematoma Evacuation

CPT-61313-FRONTAL-HEMATOMA-EVACUATION-BURR-HOLE-CRANIOTOMY

CPT 61313: Frontal Hematoma Evacuation via Burr Holes

CPT-61314-NEUROSURGICAL-HEMATOMA-EVACUATION-BURR-HOLES

CPT 61314: Neurosurgical Hematoma Evacuation, Burr Holes

CPT-61315-POSTERIOR-FOSSA-CRANIOTOMY-HEMATOMA-EVACUATION

CPT 61315: Posterior Fossa Craniotomy for Cerebellar Hematoma Evacuation

CPT-61316-CRANIAL-BONE-GRAFT-POCKETING-TEMPORARY-ABDOMINAL-STORAGE

CPT 61316: Temporary Subcutaneous Cranial Bone Graft Pocketing

CPT-61320-INTRACRANIAL-ABSCESS-DRAINAGE-SUPRATENTORIAL

CPT 61320: Supratentorial Intracranial Abscess Drainage

CPT-61321-CRANIAL-ABSCESS-DRAINAGE

CPT 61321: Cranial Drainage of Brain Abscess

CPT-61322-DECOMPRESSIVE-CRANIECTOMY-DURAPLASTY

CPT 61322: Decompressive Craniectomy with Possible Duraplasty

CPT-61323-DECOMPRESSIVE-CRANIECTOMY-PARTIAL-BRAIN-RESECTION-DURAPLASTY

CPT 61323: Decompressive Craniectomy with Partial Brain Resection and Duraplasty

Showing 1–10 of 62

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

Sign up for cpt 61304 policy alerts

Billing Code Overview

OpenPayer

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

Sign up for cpt 61304 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References