CPT 61510 Supratentorial Resection Reimbursement | OpenPayer

Summary & Overview

CPT 61510: Supratentorial Brain Tumor Resection, Bone Flap Craniotomy

CPT code 61510 identifies an open cranial procedure to remove a supratentorial brain tumor by creating a bone flap and excising the lesion. This code is used for non-meningioma tumors located above the tentorium cerebelli and is a key descriptor for neurosurgical operative reporting, utilization tracking, and hospital billing for intracranial tumor resections. Nationally, accurate use of this code affects surgical quality measurement, resource allocation for neurosurgical services, and payment determinations for high-acuity operative care.

Payors included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the procedure, the typical sites of service, commonly billed related codes, and the ICD-10 diagnostic contexts in which the code is applied. The publication also covers payer coverage patterns and common claim modifiers used in practice to reflect bilateral procedures, staged operations, professional vs. technical components, and unusual circumstances.

This summary equips billing managers, coding professionals, and clinical leaders with the operational context for 61510, highlights where coding precision matters for reimbursement and compliance, and situates the code within related cranial procedure codes for cross-reference.

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Billing Code Overview

CPT code 61510 describes a neurosurgical procedure in which a portion of the skull (a bone flap) is removed to access and excise a brain tumor located above the tentorium cerebelli. The procedure specifically applies to supratentorial intracranial tumor excision and excludes operations performed for meningioma.

Service type: Open cranial tumor resection (supratentorial)
Typical site of service: Inpatient or outpatient hospital operating room, depending on clinical complexity and perioperative care needs

Clinical & Coding Specifications

Clinical Context

A 56-year-old right-handed patient presents with progressive headaches, focal weakness, and new-onset expressive aphasia. Preoperative MRI demonstrates a 3.5 cm supratentorial intra-axial mass within the left frontal lobe causing local mass effect and midline shift. Neurology and neurosurgery evaluate the patient; after multidisciplinary discussion, the decision is made to perform a craniectomy with removal of the tumor above the tentorium cerebelli. The typical workflow includes preoperative imaging (MRI with and without contrast, possible functional MRI and tractography), anesthesia evaluation, informed consent documenting risks including neurologic deficit, and operating room setup with neuronavigation and intraoperative neuromonitoring as indicated.

On the day of surgery the patient undergoes a bone flap craniotomy (craniectomy) with microsurgical excision of the supratentorial brain tumor. Intraoperative pathology (frozen section) may be obtained; adjuncts such as ultrasound, intraoperative MRI, or awake language mapping can be used when relevant. Postoperative care includes neuroimaging (noncontrast CT immediately post-op or MRI within 24–48 hours), neurologic monitoring in a neurosurgical step-down or intensive care unit, pain control, and early mobilization. Discharge planning addresses rehabilitation needs if residual neurologic deficits (for example R47.01 aphasia) persist, and outpatient oncology/neurosurgery follow-up is arranged for final pathology (benign D33.0, malignant C71.9, or uncertain behavior D43.0) and adjuvant therapy planning.

Coding Specifications

Modifier

CPT 61600: Surgical Excision of Lesions at Anterior Cranial Fossa Base

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

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

CPT-61600-EXTRADURAL-NEOPLASM-REMOVAL-ANTERIOR-CRANIAL-FOSSA

CPT 61600: Extradural Neoplasm Removal, Anterior Cranial Fossa

CPT-61519-INFRATENTORIAL-MENINGIOMA-CRANIECTOMY-POSTERIOR-FOSSA

CPT 61519: Infratentorial Meningeal Tumor Craniectomy

CPT-61518-INFRATENTORIAL-POSTERIOR-FOSSA-CRANIECTOMY-TUMOR-EXCISION

CPT 61518: Excision of Infratentorial/Posterior Fossa Brain Tumor

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

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

61510-CRANIECTOMY-OR-CRANIOTOMY-FOR-EXCISION-OF-BRAIN-TUMOR

CPT 61510: Craniectomy/Craniotomy for Supratentorial Brain Tumor

`22`	Increased procedural services	Use when work, time, or technical difficulty substantially exceeds the usual; requires documentation of reasons for increased complexity.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the craniotomy/tumor resection and both are required for optimal outcome.
`80`	Assistant surgeon	Use when a surgical assistant performs as a general assistant to the primary surgeon.
`81`	Minimum assistant surgeon	Use when minimal assistance is provided by another surgeon.
`82`	Assistant surgeon (when qualified resident not available)	Use when a qualified resident is not available and an assistant surgeon was necessary.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure on the same day (for example a separate diagnostic cortical biopsy or placement of monitoring device) when appropriate.
`26`	Professional component	Use when billing only the professional interpretation component of an intraoperative neurophysiology study or imaging service billed separately.
`53`	Discontinued procedure	Use if the craniotomy/craniectomy was started but discontinued due to extenuating circumstances or patient instability.
`52`	Reduced services	Use when a lesser procedure than described by the code was performed (for example limited resection).
`78`	Unplanned return to operating room for related procedure during the postoperative period	Use for an unplanned reoperation for a complication related to the initial craniectomy/tumor resection.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`58`	Staged or related procedure during postoperative period	Use when a planned staged craniotomy or staged tumor resection is performed.
`63`	Procedure performed on infants less than 4 kg	Use when applicable to very low-weight pediatric patients (rare for this code).
`55`	Postoperative management only	Use when only postoperative care is billed by the surgeon separate from the original global surgical code.

Taxonomy Code	Specialty	Notes
`207T00000X`	Neurological Surgery	Primary specialty performing craniectomy and supratentorial tumor excision.
`208600000X`	Surgery	General surgery taxonomy; may appear for surgical providers with broad surgery classification in certain credentialing contexts.
`207ZP0102X`	Pediatric Neurosurgery	Specialty for pediatric patients undergoing similar procedures when treating infants/children.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C71.9`	Malignant neoplasm of brain, unspecified	Indicates a primary malignant brain tumor that may require craniectomy and tumor excision for diagnosis, cytoreduction, or symptom relief.
`D33.0`	Benign neoplasm of brain, supratentorial	Represents benign supratentorial tumors (for example low-grade gliomas or other benign masses) that are amenable to surgical resection via craniectomy.
`D43.0`	Neoplasm of uncertain behavior of brain, supratentorial	Used when the lesion’s behavior is uncertain preoperatively; surgical excision provides tissue for definitive diagnosis.
`G93.5`	Compression of brain	Reflects mass effect from the lesion causing raised intracranial pressure or focal deficits; craniectomy and tumor removal may be indicated to relieve compression.
`R47.01`	Aphasia	A presenting neurologic deficit (language impairment) that can result from a dominant hemisphere supratentorial tumor and is relevant to preoperative planning and functional mapping.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61512`	Craniectomy, trephination, bone flap craniotomy; not excising meningioma, supratentorial (abbreviated)	Alternative code used for supratentorial craniotomy when excising tumors other than meningioma; selection depends on operative intent and tumor type.
`61514`	Craniectomy, trephination, bone flap craniotomy; not excising brain abscess, supratentorial (abbreviated)	Related code describing supratentorial craniotomy for different pathology (brain abscess); used when the indication is an abscess rather than tumor.
`61516`	Craniectomy, trephination, bone flap craniotomy; not excising/fenestrating cyst, supratentorial (abbreviated)	Related code for craniotomy when the target is a cystic lesion rather than tumor; used when operative technique and intent align with cyst fenestration rather than tumor excision.

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