CPT 61519 Infratentorial Craniectomy Benchmarks | OpenPayer

Summary & Overview

CPT 61519: Infratentorial Meningeal Tumor Craniectomy

CPT code 61519 represents a specialized neurosurgical craniectomy to remove meningeal tumors located below the tentorium cerebelli or within the posterior fossa. Nationally, this code captures high-acuity operative care for tumors in anatomically complex, posterior intracranial spaces where risks to the brainstem and cerebellum are significant. Use of this code supports tracking of surgical volumes, resource utilization, and policy decisions related to high-complexity neurosurgery.

Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication provides a concise overview of clinical context for the procedure, common coding relationships, and payer coverage considerations relevant to hospitals and surgical practices.

Readers will learn the clinical scope of the procedure, typical site-of-service expectations, and how the code relates to adjacent neurosurgical codes. The report summarizes national benchmarking themes and highlights policy and coding updates that affect high-complexity cranial tumor resections. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnited HealthcareMedicare61519CPTneurosurgerycraniectomymeningiomaposterior-fossainfratentorialbrain-tumor-surgery

Billing Code Overview

CPT code 61519 describes a neurosurgical procedure in which the surgeon performs a craniectomy (removal of a portion of skull bone) to excise a tumor of the meninges located below the tentorium cerebelli or within the posterior fossa. Service type: Neurosurgical tumor resection (infratentorial/posterior fossa craniectomy). Typical site of service: Hospital operating room, often with postoperative inpatient recovery due to the complexity and proximity to brainstem structures.

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient presents with progressive headaches, gait instability, and new-onset aphasia. Neuroimaging (MRI) demonstrates a contrast-enhancing extra-axial mass located below the tentorium in the posterior fossa, consistent with a meningioma compressing the cerebellum and adjacent brainstem structures. Neurological exam shows cerebellar signs and mild expressive language disturbance. The neurosurgical team schedules a craniotomy/craniectomy to remove a portion of skull bone and excise the infratentorial meningeal tumor, with intraoperative neurophysiologic monitoring and microsurgical techniques. The typical workflow includes preoperative evaluation (history, imaging review, anesthesia assessment), informed consent documenting risks (bleeding, infection, neurological deficit), preoperative localization and positioning, general endotracheal anesthesia, skull bone removal (craniectomy), tumor resection with hemostasis, dural closure, bone flap management or craniectomy defect planning, and postoperative ICU monitoring with serial neurologic checks and follow-up imaging. Typical sites of service are an inpatient hospital operating room or an ambulatory surgical center only when appropriate resources exist, with postoperative recovery in a post-anesthesia care unit and commonly transfer to an intensive care unit for neurologic observation.

Coding Specifications

Modifier	Description	When to Use
`62`	Two surgeons	When two surgeons of different specialties or assisting expertise perform distinct portions of the procedure concurrently or sequentially.

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

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

CPT-61510-SUPRATENTORIAL-BRAIN-TUMOR-RESECTION

CPT 61510: Supratentorial Brain Tumor Resection, Bone Flap Craniotomy

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

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

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

CPT 61510: Craniectomy/Craniotomy for Supratentorial Brain Tumor

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

CPT 61600: Extradural Neoplasm Removal, Anterior Cranial Fossa

Taxonomy Code	Specialty	Notes
`207T00000X`	Neurological Surgery	Primary specialty performing intracranial tumor resections and complex posterior fossa surgery.
`208600000X`	Surgery	General surgeons may be involved in perioperative care; not typically primary for posterior fossa tumor resection.
`207ZP0102X`	Pediatric Neurosurgery	Pediatric neurosurgeons perform similar procedures in children when applicable.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D32.0`	Benign neoplasm of cerebral meninges	Represents meningiomas of the cerebral meninges that can occur infratentorially and are an indication for surgical excision when symptomatic or mass effect is present.
`C71.6`	Malignant neoplasm of cerebellum	Malignant tumors of the cerebellum that may require craniectomy and resection for diagnosis, debulking, or decompression.
`D33.1`	Benign neoplasm of brain, infratentorial	Covers benign intra-axial or adjacent tumors in the infratentorial compartment requiring surgical management.
`G93.5`	Compression of brain	Reflects mass-effect physiology from tumor causing increased intracranial pressure or focal compression that necessitates surgical decompression.
`R47.01`	Aphasia	A presenting neurologic deficit that may be related to tumor location or mass effect; relevant to preoperative and postoperative functional assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61520`	Craniectomy for excision of brain tumor, infratentorial or posterior fossa (e.g., acoustic neuroma)	Closely related operative code for infratentorial tumor excision; may be used for similar posterior fossa tumor resections depending on operative approach and documentation.

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