Summary & Overview
CPT 61524: Posterior Fossa Cyst or Tumor Excision/Drainage
CPT code 61524 denotes a neurosurgical cranial procedure to remove a portion of skull bone and excise or open a cyst or tumor located below the tentorium cerebelli or within the posterior fossa to facilitate drainage or resection. This is a high-acuity operative code used for lesions near the brainstem and cerebellum and is clinically significant because these procedures carry substantial operative risk and resource utilization across hospital systems nationally. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview, typical sites of service, and the operational context for 61524. The publication summarizes national benchmarking context for utilization and reimbursement patterns, highlights relevant policy or coverage considerations affecting payment and prior authorization, and provides clinical context to inform coding and billing workflows for posterior fossa cyst or tumor procedures. Data not available in the input is noted where applicable. The focus is national in scope and intended for coding, billing, and health policy professionals seeking a clear reference for CPT code 61524.
Billing Code Overview
CPT code 61524 describes a neurosurgical procedure in which a portion of the skull bone (craniectomy/craniotomy) is removed and a cyst or tumor located below the tentorium cerebelli or within the posterior fossa is opened or excised to allow drainage or removal. The procedure targets lesions in the posterior cranial fossa near the brainstem and cerebellum.
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Service type: Neurosurgical cyst or posterior fossa tumor excision/ drainage (cranial surgery)
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Typical site of service: Hospital operating room or inpatient surgical setting where neurosurgical procedures on the posterior fossa are performed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with progressive headache, cerebellar signs (ataxia, dysmetria), nausea/vomiting, or focal neurologic deficits. Neuroimaging (MRI/CT) demonstrates a posterior fossa or infratentorial cystic lesion such as an arachnoid cyst, epidermoid cyst, or cystic posterior fossa tumor causing mass effect or obstructive hydrocephalus. The neurosurgical team evaluates the patient preoperatively with neurological exam, contrast brain MRI, and basic labs. The patient is admitted to a hospital with neurosurgical capability; anesthesia evaluation is completed and informed consent obtained. In the operating room under general endotracheal anesthesia, a posterior fossa craniectomy or craniotomy is performed to expose the lesion. The surgeon removes a portion of skull bone and either excises the cyst or creates an opening (fenestration) to drain cerebrospinal fluid from the cyst into normal CSF spaces. Intraoperative neurophysiologic monitoring may be used. The specimen (if excised) is sent to pathology. Postoperatively the patient is observed in a neurosurgical intensive care unit or step-down unit for neurologic monitoring, with follow-up imaging to confirm decompression and to evaluate for complications such as hemorrhage or infection. Typical sites of service are an inpatient hospital operating room or an ambulatory surgical center when appropriate, but most of these procedures occur inpatient due to potential for postoperative monitoring and complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier specified (default) |