Summary & Overview
CPT 61517: Intraoperative Local Chemotherapy Implantation During Cranial Tumor Resection
CPT code 61517 denotes an add-on intraoperative chemotherapy implantation performed at the time of skull bone removal and tumor excision. This procedure is used when resection is incomplete or there is risk of residual tumor cells, delivering localized chemotherapy directly into the surgical cavity. The code is clinically significant because it represents a highly specialized adjunct to neurosurgical tumor management that can impact perioperative planning, device use, and payment bundling nationally.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent and operative context for the code, typical sites of service, and payer coverage considerations. The report outlines where this add-on fits within surgical workflow, common billing modifiers and administrative notes (listed separately), and practical implications for coding accuracy and claims adjudication.
This summary frames the clinical context and billing purpose of CPT code 61517, equipping payers, providers, and billing professionals with the information needed to identify when the code applies, understand its role as an adjunct to craniectomy/craniotomy tumor resection, and locate further details on claims processing and documentation requirements. Data not available in the input is noted where relevant in subsequent sections.
Billing Code Overview
CPT code 61517 is an add-on procedure used when a provider implants a chemotherapy drug at the time of a craniectomy or craniotomy tumor resection. The service is performed when tumor resection is incomplete or when there is concern for residual cancer cells within the operative field; the implant delivers localized chemotherapy directly to the surgical site.
Service type: Surgical adjunct — intraoperative local chemotherapy implantation
Typical site of service: Hospital operating room (during neurosurgical cranial tumor resection)
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with a recurrent high-grade glioma involving the left frontal lobe. Preoperative MRI demonstrates a dominant enhancing tumor with areas of suspected residual microscopic disease at the resection margins. The neurosurgical team performs a craniotomy with partial skull bone removal and tumor excision. At the time of resection, the surgeon places an implanted chemotherapy wafer into the resection cavity to deliver local chemotherapy to areas at high risk for residual tumor cells. The intraoperative workflow includes anesthesia induction, neuronavigation setup, craniotomy and dural opening, tumor debulking with intraoperative assessment of margins, placement of the chemotherapy implant(s) into the cavity, watertight dural closure, cranial bone flap management or craniectomy closure, and standard postoperative monitoring in the neurosurgical recovery unit. The procedure is documented with operative details (extent of resection, number and type of implants), informed consent noting risks specific to local chemotherapeutic implantation, and postoperative plan including imaging and adjuvant systemic therapy considerations.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons work together as primary surgeons performing distinct portions of the craniotomy/resection and implant placement. |