Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesCraniectomy or Craniotomy ProceduresCPT cpt-61520-acoustic-neuroma-resection-posterior-fossa
    Ask Trek AI about this page

    CPT 61520: Cerebellopontine Angle (Acoustic Neuroma) Tumor Excision

    Medicare pays $3493 on average nationally for this procedure.

    CPT code 61520 describes surgical removal of a cerebellopontine angle (acoustic neuroma) tumor via a suboccipital craniectomy, a neurosurgical procedure that involves removal of part of the skull in the posterior fossa to access and excise a tumor located below the tentorium cerebelli near the brainstem; service type: neurosurgical tumor resection; typical site of service: hospital operating room or tertiary care surgical center.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

    Customize your policy alerts

    Sign up for cpt 61520 policy alerts

    Get alerted when payer policies referencing 61520 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old patient presents with progressive unilateral hearing loss, tinnitus, and intermittent imbalance. MRI of the brain with contrast demonstrates a 2.5–3.5 cm enhancing mass in the cerebellopontine angle consistent with a vestibular schwannoma (acoustic neuroma) located below the tentorium cerebelli in the posterior fossa. The neurosurgical team schedules a posterior fossa craniotomy with excision of the cerebellopontine angle tumor. Preoperative workflow includes neurosurgical evaluation, audiology testing, brain MRI, anesthesia assessment, and informed consent documenting surgical risks including cranial nerve deficits, CSF leak, and need for intraoperative monitoring. The procedure is typically performed in an inpatient operating room under general anesthesia with intraoperative neurophysiologic monitoring (brainstem auditory evoked potentials and facial nerve monitoring). Postoperative care involves ICU or monitored step-down observation for hemodynamic and neurologic status, pain control, wound care, early mobilization, and follow-up MRI at an interval to assess extent of resection.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    61520Craniectomy or craniotomy for intracranial tumor; cerebellopontine angle (e.g., acoustic neuroma), below tentoriumThe primary procedure code describing posterior fossa craniotomy and excision of a cerebellopontine angle tumor.
    95851Electroencephalogram (monitoring) during surgical procedures with interpretation and reportUsed when intraoperative EEG or neurophysiologic monitoring is billed separately for neuromonitoring support.
    92620Evaluation of central auditory function; evoked auditory potentialsBilled for intraoperative or perioperative auditory evoked potential testing related to hearing preservation.
    61790Stereotactic computer-assisted procedure; cranial, localization for lesionMay be performed preoperatively for planning or intraoperatively for navigation assistance.
    61254Craniectomy or craniotomy, posterior fossa, with microvascular decompression or approachRelated posterior fossa approach codes for procedures that may be performed in combination or in differential coding scenarios.
    99152Anesthesia for procedures on the head and neck — initial 90 minutesRepresents anesthesia services typically reported by anesthesiology for prolonged intracranial surgery (actual anesthesia coding varies by payer and ASA guidelines).

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    103TC2200XClinical Child & Adolescent PsychologistA psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents …
    173C00000XReflexologistReflexologists perform a non-invasive complementary modality involving thumb and finger techniques to apply alternating pressure to the reflexes withi…
    2080T0004XPediatric Transplant Hepatology PhysicianA pediatrician with expertise in transplant hepatology encompasses the special knowledge and skill required of pediatric gastroenterologists to care f…
    208200000XPlastic Surgery PhysicianA plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal sys…
    207N00000XDermatology PhysicianA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…

    Related ICD-10-CM Codes

    18 rows

    ICD-10-CM CodeDescription
    C71.9Malignant neoplasm of brain, unspecified
    C75.1Malignant neoplasm of pituitary gland
    D33.3Benign neoplasm of cranial nerves
    D43.9Neoplasm of uncertain behavior of central nervous system, unspecified
    F05Delirium due to known physiological condition
    G44.1Vascular headache, not elsewhere classified
    G47.9Sleep disorder, unspecified
    G51.1Geniculate ganglionitis
    G93.1Anoxic brain damage, not elsewhere classified
    H90.3Sensorineural hearing loss, bilateral

    Showing 1–10 of 18

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    9 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

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

    CPT 61304: Supratentorial Craniotomy for Frontal Brain Inspection

    CPT-61305-POSTERIOR-FOSSA-INSPECTION-SUBTENTORIAL-APPROACH

    CPT 61305: Posterior Fossa Cranial Exploration

    CPT-61312-SUPRATENTORIAL-HEMATOMA-EVACUATION-CRANIOTOMY

    CPT 61312: Supratentorial Hematoma Evacuation, Craniotomy/Craniectomy

    CPT-61313-FRONTAL-HEMATOMA-EVACUATION-BURR-HOLE-CRANIOTOMY

    CPT 61313: Craniotomy/Burr Hole Evacuation of Intracranial Hematoma

    CPT-61314-NEUROSURGICAL-HEMATOMA-EVACUATION-BURR-HOLES

    CPT 61314: Evacuation of Subdural Hematoma via Burr Holes or Craniotomy

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

    CPT 61315: Suboccipital Craniotomy for Cerebellar Hematoma Drainage

    CPT-61316-CRANIAL-BONE-GRAFT-POCKETING-TEMPORARY-ABDOMINAL-STORAGE

    CPT 61316: Temporary Subcutaneous Cranial Bone Graft Placement

    CPT-61320-INTRACRANIAL-ABSCESS-DRAINAGE-SUPRATENTORIAL

    CPT 61320: Craniotomy for Drainage of Intracranial Abscess

    CPT-61321-CRANIAL-ABSCESS-DRAINAGE

    CPT 61321: Craniotomy to Drain Brain Abscess

    CPT-61322-DECOMPRESSIVE-CRANIECTOMY-DURAPLASTY

    CPT 61322: Decompressive Craniectomy for Elevated Intracranial Pressure

    Showing 1–10 of 62

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.