CPT 61312 Supratentorial Hematoma Reimbursement | OpenPayer

Summary & Overview

CPT 61312: Supratentorial Intracranial Hematoma Evacuation

CPT code 61312 represents neurosurgical evacuation of supratentorial intracranial hematoma through scalp incision with craniotomy or craniectomy and suction. This procedure addresses life‑threatening collections of blood above the tentorium cerebella that follow head trauma or intracranial hemorrhage. Nationally, timely surgical evacuation can be critical to neurologic outcomes and hospital resource use, making the procedure significant for acute care, reimbursement policy, and surgical quality measurement.

This publication covers major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and site-of-service expectations, a summary of common billing modifiers and their typical use cases, and notes on payer coverage considerations where available. The report also outlines what data is available for benchmarking and which elements are not provided in the input.

Intended for coding professionals, hospital billing leaders, and policy analysts, the content provides practical context for claims processing and programmatic review without offering clinical recommendations. It highlights operational implications for inpatient surgical services and emergency neurosurgery workflows, and identifies gaps where additional payer- or diagnosis-specific guidance may be required.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare61312CPTneurosurgeryintracranial hematomacraniotomyinpatient surgeryemergency neurosurgerysurgical evacuationhead trauma

Billing Code Overview

CPT code 61312 describes surgical evacuation of intracranial hematoma located in the supratentorial region of the brain. A hematoma is an abnormal collection of blood outside blood vessels following internal hemorrhage; supratentorial hematomas occur above the tentorium cerebella and are often caused by traumatic head injury. This CPT code covers procedures in which the surgeon performs an incision of the scalp and creates a craniotomy or craniectomy to access and remove the hematoma, commonly using suction and direct surgical techniques.

Service type: Neurosurgical evacuation of supratentorial intracranial hematoma
Typical site of service: Inpatient hospital operating room or emergency neurosurgical suite

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

Clinical & Coding Specifications

Clinical Context

A 68-year-old male presents to the emergency department after a ground-level fall with progressive headache, decreased level of consciousness, and a focal right-sided weakness. Non-contrast head CT demonstrates an acute left-sided subdural hematoma with midline shift and mass effect. The patient is hemodynamically stable but has worsening neurologic exam consistent with increased intracranial pressure. Neurosurgery is consulted and determines operative evacuation is required. The clinical workflow includes emergent preoperative evaluation (consent, coagulation correction if needed), general anesthesia in the operating room, scalp incision and craniotomy, evacuation of the subdural hematoma by suction and hemostasis, possible placement of a subdural drain, closure, and postoperative intensive care monitoring with repeat imaging.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or resources substantially exceed the typical for hematoma evacuation (e.g., extensive hemorrhage, prolonged operative time beyond typical).
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and additional risk necessitates unusual anesthetic management for the procedure.

CPT 61521: Skull Base or Posterior Fossa Tumor Resection

CPT-61538-TEMPORAL-LOBECTOMY-WITH-INTRAOPERATIVE-ECOG

CPT 61538: Temporal Lobectomy with Intraoperative Electrocorticography

CPT-61557-BILATERAL-FRONTAL-CRANIAL-VAULT-REMODELING-CRANIOSYNOSTOSIS

CPT 61557: Bilateral Frontal Cranial Vault Remodeling for Craniosynostosis

CPT-61304-ANTERIOR-SKULL-CRANIOTOMY-BRAIN-INSPECTION

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

CPT-61330-ORBITAL-DECOMPRESSION-FOR-PROPTOSIS-OR-FRACTURE

CPT 61330: Orbital Decompression for Proptosis or Orbital Roof Fracture

CPT-61340-TEMPORAL-CRANIECTOMY-DECOMPRESSION-INTRACRANIAL-PRESSURE

CPT 61340: Temporal Craniectomy for Intracranial Pressure Decompression

CPT-61450-TRIGEMINAL-GANGLION-SECTIONING

CPT 61450: Section/Decompression of Gasserian Ganglion for Trigeminal Neuralgia

61518-CRANIECTOMY-FOR-EXCISION-OF-BRAIN-TUMOR-INFRATENTORIAL-OR

CPT 61518: Craniectomy for Infratentorial/Posterior Fossa Brain Tumor Excision

CPT-61514-CRANIOTOMY-EXCISION-SUPRATENTORIAL-BRAIN-ABSCESS

CPT 61514: Craniotomy for Excision of Supratentorial Brain Abscess

CPT-61571-INTRACRANIAL-FOREIGN-BODY-REMOVAL-BRAIN-WOUND-REPAIR

CPT 61571: Intracranial Foreign Body Removal and Brain Wound Repair

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Taxonomy Code	Specialty	Notes
`2084P0800X`	Neurological Surgery	Primary specialty performing craniotomy and hematoma evacuation.
`208VP0000X`	Vascular Neurology	May be involved for hemorrhagic stroke evaluation and perioperative management.
`207Q00000X`	Physician Assistant	Common first assist or intraoperative assistant in neurosurgical procedures.
`2086S0122X`	Critical Care Medicine	Provides perioperative ICU management after hematoma evacuation.
`207L00000X`	Registered Nurse First Assistant	Common operating room assistant role during neurosurgical cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S06.5X0A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Most common indication for supratentorial hematoma evacuation after head trauma.
`S06.5X1A`	Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter	Indicates trauma with altered consciousness prompting urgent surgical evacuation.
`I62.00`	Nontraumatic subdural hemorrhage, unspecified	Nontraumatic (spontaneous) subdural hematoma that may require surgical evacuation.
`I61.9`	Nontraumatic intracerebral hemorrhage, unspecified	Intracerebral hemorrhage with mass effect that can coexist with subdural collections and require craniotomy.
`S06.4X0A`	Epidural hemorrhage without loss of consciousness, initial encounter	Epidural hematoma is another traumatic extra-axial collection treated with evacuation.
`S06.9X0A`	Intracranial injury, unspecified, without loss of consciousness, initial encounter	Used when specific intracranial hemorrhage type is not yet specified during initial coding.
`G93.6`	Cerebral edema	Associated condition that may accompany large hematomas and influence surgical decision-making.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61312`	Craniotomy or craniectomy for evacuation of hematoma, supratentorial (separate listing)	Primary code for surgical evacuation of supratentorial subdural or extradural hematoma.
`61304`	Craniotomy including decompression for traumatic intracranial hemorrhage, initial; supratentorial	May be used for decompressive craniectomy when indicated for refractory intracranial hypertension alongside hematoma evacuation.
`61150`	Burr hole(s) for drainage of hematoma (subdural or epidural)	Less invasive alternative used for select subdural evacuations or initial temporizing procedure prior to craniotomy.
`61210`	Craniectomy, intracranial, supratentorial; removal of bone flap (decompressive)	Used when bone flap is not replaced (decompressive craniectomy) as part of hemorrhage management.
`61154`	Placement of intracranial pressure monitor (intraventricular catheter)	Performed pre- or intraoperatively for intracranial pressure monitoring in severe cases.
`61840`	Placement of ventricular catheter, with or without reservoir or valve	Performed if ventriculostomy is required for cerebrospinal fluid diversion or pressure monitoring during management.

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