CPT 61314 Neurosurgical Hematoma Evacuation Reimbursement | OpenPayer

Summary & Overview

CPT 61314: Neurosurgical Hematoma Evacuation, Burr Holes

Headline: CPT code 61314: Neurosurgical hematoma evacuation that relieves intracranial pressure

Lead: CPT code 61314 represents a neurosurgical procedure to drain subdural or epidural hematomas by creating burr holes and potentially opening the skull to access brain regions beneath the tentorium. The intervention is acute and often emergent, intended to relieve mass effect and prevent secondary brain injury.

What the code represents and why it matters: CPT code 61314 captures a high-acuity neurosurgical service used to treat intracranial hematomas resulting from trauma, medical procedures, or spontaneous hemorrhage. Nationally, this code is relevant for hospital-based surgical reporting, resource intensity planning, and acute-care quality monitoring because timely evacuation can be life-saving and drives significant inpatient resource use.

Key payers covered: This summary addresses coverage and billing considerations across major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Overview of what readers will learn: The publication provides clinical context for the procedure, expected sites of service, typical care setting, common billing modifiers (listed separately), and what to expect in payer coverage approaches and authorization practices. Readers will find benchmarks, policy updates, and coding considerations relevant to hospital billing teams and revenue cycle managers.

Data availability: Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, or related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 61314neurosurgeryhematoma evacuationburr holescraniotomyinpatient surgeryacute caresurgical codingbrain hemorrhage

Billing Code Overview

CPT code 61314 describes a surgical procedure to drain a hematoma located on or beneath the dura by creating burr holes and, if needed, opening the skull to access the brain below the tentorium. The procedure addresses abnormal collections of blood caused by trauma, procedural complications, or spontaneous intracranial hemorrhage from stroke.

Service type: Neurosurgical hematoma evacuation involving burr holes and possible craniotomy
Typical site of service: Inpatient operating room or emergency/urgent surgical setting in a hospital

Clinical & Coding Specifications

Clinical Context

A 68-year-old male presents to the emergency department after a ground-level fall with sudden decreased level of consciousness and a severe headache. Head CT demonstrates a large acute subdural hematoma with midline shift and increased intracranial pressure. The neurosurgery team performs an urgent burr hole drainage and possible craniotomy to evacuate the hematoma and decompress the intracranial compartment. Preoperative workflow includes rapid neurological assessment, airway management, informed consent from next of kin, blood type and crossmatch, and transfer to the operating room. Intraoperative workflow includes burr hole placement (single or multiple), evacuation of clot, hemostasis, irrigation, possible placement of a subdural drain, and wound closure. Postoperative care involves ICU monitoring, repeat head CT to confirm evacuation and brain re-expansion, intracranial pressure management, and documentation of operative findings and any complications.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Reporting the primary procedure when no modifier applies
`11`	Principal procedure	When this procedure is the primary service performed

CPT 61512: Craniotomy for Supratentorial Meningioma Excision

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

CPT 61315: Posterior Fossa Craniotomy for Cerebellar Hematoma Evacuation

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

CPT 61304: Supratentorial Brain Inspection via Anterior Cranial Access

61519-CRANIECTOMY-FOR-EXCISION-OF-BRAIN-TUMOR-INFRATENTORIAL-OR

CPT 61519: Craniectomy for Excision of Brain Tumor, Infratentorial or Posterior Fossa

CPT-61501-CRANIOTOMY-INFECTED-SKULL-DEBRIDEMENT

CPT 61501: Craniotomy for Removal of Infected Skull Bone

CPT-61460-CRANIAL-NERVE-EXPOSURE-ACOUSTIC-NEUROMA

CPT 61460: Cranial Nerve Exposure for Acoustic Neuroma

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

CPT 61514: Craniotomy for Excision of Supratentorial Brain Abscess

CPT-61536-RESECTIVE-EPILEPSY-SURGERY-EXCISION-EPILEPTOGENIC-FOCUS

CPT 61536: Resection of Epileptogenic Focus via Craniotomy

CPT-61320-INTRACRANIAL-ABSCESS-DRAINAGE-SUPRATENTORIAL

CPT 61320: Supratentorial Intracranial Abscess Drainage

CPT-61552-CRANIAL-VAULT-REMODELING

CPT 61552: Cranial Vault Remodeling Procedure

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Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing cranial hematoma evacuation
208D00000X	Neurological Surgery	Alternative taxonomy for neurosurgical practitioners
208U00000X	Critical Care Medicine	Often provides perioperative and ICU management
367A00000X	Anesthesiology	Provides general anesthesia and airway management during the procedure
207RC0000X	Emergency Medicine	Initiates emergent evaluation and stabilization prior to operative transfer

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S06.5X0A`	Traumatic subdural hemorrhage without loss of consciousness, initial encounter	Common traumatic indication for supratentorial hematoma evacuation
`S06.5X2A`	Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter	Indicates more severe traumatic brain injury often requiring surgical drainage
`I62.0`	Nontraumatic extradural hemorrhage	Spontaneous epidural-type hemorrhage that may require burr hole drainage
`I62.1`	Nontraumatic subdural hemorrhage	Spontaneous subdural hematoma from coagulopathy or ruptured bridging veins
`I61.9`	Intracerebral hemorrhage, unspecified	Intracerebral bleeding that can co-exist with subdural collections and influence surgical decision-making
`S06.6X0A`	Traumatic subarachnoid hemorrhage, initial encounter	May be present with other intracranial hemorrhages and affects operative planning
`D68.9`	Coagulation defect, unspecified	Underlying coagulopathy that predisposes to intracranial bleeding and affects timing and risk of surgery
`S06.5X9A`	Traumatic subdural hemorrhage, unspecified, initial encounter	General trauma diagnosis commonly associated with this procedure

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61314`	Burr hole(s) with drainage of hematoma or abscess, supratentorial (open or closed)	Primary procedure for evacuation of subdural or epidural hematoma above the tentorium
`61312`	Burr hole(s) with drainage of hematoma or abscess, infratentorial	Related when hematoma is located below the tentorium (posterior fossa) requiring separate code
`61520`	Craniotomy, supratentorial, for excision of lesion or evacuation of hematoma	Used when a formal craniotomy (larger bone flap) is performed instead of burr holes
`61254`	Ventricular catheter placement (external ventricular drain)	Performed when cerebrospinal fluid diversion or intracranial pressure monitoring is required alongside hematoma evacuation
`99152`	Moderate sedation services (initial 15 minutes) provided by the same physician performing procedure	When procedural moderate sedation is used instead of general anesthesia (report per payer rules)
`99153`	Moderate sedation services (each additional 15 minutes)	Adjunct reporting for extended sedation during prolonged operative or bedside drainage procedures

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