CPT 61526 Transtemporal Resection Reimbursement | OpenPayer

Summary & Overview

CPT 61526: Transtemporal Resection of Cerebellopontine Angle Tumor

CPT code 61526 denotes a neurosurgical craniectomy/craniotomy performed to remove a cerebellopontine angle tumor via a transtemporal approach. This code captures a complex, specialist operative service that is clinically significant due to the technical demands of accessing lesions near critical cranial nerve and brainstem structures and the potential for substantial resource use and risk. Nationally, accurate coding for these procedures affects clinical registries, quality measurement, and hospital and payer case-mix accounting.

Key payers considered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, expected site of service, and benchmarking perspectives relevant to payers and providers. The publication summarizes typical utilization patterns, documentation and coding implications, and policy factors that influence coverage and payment practices for high-complexity cranial tumor resections. Where available, benchmarks and payer coverage notes are presented; where input data is missing, the report indicates that data is not available in the input. The content is intended for a national audience of clinicians, coding professionals, and policy analysts seeking concise information about the clinical service represented by CPT code 61526.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare61526CPTneurosurgerycraniotomycerebellopontine angletumor resectiontranstemporal approach

Billing Code Overview

CPT code 61526 describes a surgical procedure in which the provider removes a portion of the skull (craniectomy/craniotomy) and excises a cerebellopontine angle tumor using a transtemporal approach. The approach traverses the temporal bone region to access lesions at the cerebellopontine angle while minimizing retraction of the brain.

Service type: Neurosurgical tumor resection (cranial operative procedure)
Typical site of service: Inpatient or outpatient hospital operating room (neurosurgery service)

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–65-year-old adult presenting with progressive unilateral hearing loss, tinnitus, disequilibrium, and intermittent facial numbness. Imaging with contrast-enhanced MRI demonstrates a cerebellopontine angle mass consistent with an acoustic neuroma/vestibular schwannoma or other CPA tumor compressing the brainstem and cranial nerves. After multidisciplinary evaluation (neurosurgery, neuro-otology, anesthesiology), the patient is scheduled for microsurgical resection via a transtemporal approach with a temporal craniotomy to minimize cerebellar retraction.

Preoperative workflow includes audiology testing, cranial nerve baseline assessment, informed consent, and perioperative planning for intraoperative neurophysiologic monitoring (brainstem auditory evoked potentials and facial nerve monitoring). The procedure is performed in an operating room under general anesthesia. The surgeon performs a temporal craniotomy, dural opening, microsurgical dissection of the cerebellopontine angle, and tumor excision with attention to preservation of cranial nerve VII and VIII. Hemostasis and dural closure follow, with possible skull reconstruction.

Typical immediate postoperative care occurs in a neurosurgical intensive care or step-down unit with neurologic checks, monitoring for CSF leak, cranial nerve function, and pain control. Postoperative imaging and outpatient follow-up with audiology and neurosurgery are routine for surveillance and rehabilitation.

Coding Specifications

Modifier	Description	When to Use
`11`

CPT 61543: Hemispherectomy or Extensive Cerebral Resection

CPT-61521-SKULL-BASE-POSTERIOR-FOSSA-TUMOR-RESECTION

CPT 61521: Skull Base or Posterior Fossa Tumor Resection

CPT-61460-CRANIAL-NERVE-EXPOSURE-ACOUSTIC-NEUROMA

CPT 61460: Cranial Nerve Exposure for Acoustic Neuroma

CPT-61541-CORPUS-CALLOSOTOMY-CRANIOTOMY

CPT 61541: Corpus Callosotomy via Craniotomy

CPT-61340-TEMPORAL-CRANIECTOMY-DECOMPRESSION-INTRACRANIAL-PRESSURE

CPT 61340: Temporal Craniectomy for Intracranial Pressure Decompression

CPT-61575-TRANSORAL-SKULL-BASE-BRAIN-STEM-UPPER-SPINAL-CORD-APPROACH

CPT 61575: Transoral Skull Base, Brain Stem, Upper Spinal Cord Approach

CPT-61531-SUBDURAL-ELECTRODE-PLACEMENT-FOR-SEIZURE-MONITORING

CPT 61531: Subdural Electrode Placement for Seizure Monitoring

CPT-61330-ORBITAL-DECOMPRESSION-FOR-PROPTOSIS-OR-FRACTURE

CPT 61330: Orbital Decompression for Proptosis or Orbital Roof Fracture

CPT-61566-TEMPORAL-LOBE-MEDIAL-TEMPORAL-RESECTION-HIPPOCAMPUS-AMYGDALA

CPT 61566: Temporal Lobe Resection of Hippocampus and Amygdala

CPT-61537-TEMPORAL-LOBE-RESECTION-FOR-EPILEPSY

CPT 61537: Temporal Lobe Resection for Epilepsy

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Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing microsurgical cerebellopontine angle tumor resections.
207X00000X	Otolaryngology — Head & Neck Surgery	Neuro-otology/ENT surgeons who manage skull base tumors and hearing preservation strategies.
2080P0206X	Neurological Surgery — Pediatric	Applied if pediatric patients require specialized neurosurgical expertise.
207L00000X	Plastic and Reconstructive Surgery	Involved when complex skull reconstruction or soft-tissue closure is required.
221N00000X	Anesthesiology	Provides general anesthesia and perioperative anesthesia care, including advanced monitoring.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D33.3`	Benign neoplasm of cranial nerves	Common diagnosis for vestibular schwannoma / acoustic neuroma located in the cerebellopontine angle.
`C71.7`	Malignant neoplasm of brain, infratentorial structures	Used when CPA tumor is malignant and involves infratentorial brain structures.
`D43.2`	Neoplasm of uncertain behavior of brain, infratentorial structures	Applied when pathology is uncertain preoperatively and tumor behavior is unclear.
`G51.0`	Bell's palsy	Included as a related cranial nerve VII disorder for differential diagnosis and for documentation of preoperative facial nerve dysfunction.
`H90.3`	Sensorineural hearing loss, unilateral	Frequently present as a presenting symptom and relevant to surgical planning and outcome tracking.
`R42`	Dizziness and giddiness	Symptom code often documented preoperatively for balance disturbances caused by CPA tumors.
`G44.1`	Vascular headache, not elsewhere classified	Headache symptoms that may be associated with posterior fossa mass effect and are documented in the clinical record.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61526`	Craniectomy or craniotomy for excision of cerebellopontine angle tumor; transtemporal approach	Primary operative code for transtemporal resection of CPA tumors.
`61618`	Craniectomy or craniotomy, supratentorial, for excision of brain tumor; intratemporal approach (Note: used for lesions requiring different approach)	Alternative craniotomy codes for adjacent skull base or temporal lobe tumor resections depending on tumor location and surgeon approach selection.
`61624`	Craniectomy or craniotomy for posterior fossa tumor; suboccipital approach	Commonly used when a suboccipital (retrosigmoid) approach is chosen instead of transtemporal technique.
`64561`	Insertion of intracranial monitoring electrode (e.g., for auditory brainstem response monitoring)	May be performed for intraoperative neurophysiologic monitoring setup when separate placement is required and billable.
`61254`	Craniectomy for tumor; suboccipital posterior fossa, supracerebellar approach	Related posterior fossa approaches that can be part of the differential coding set when planning tumor access.
`20900`	Tissue grafting, skull and calvarium; cranioplasty (may be unlisted/varied codes)	Codes for skull reconstruction or cranioplasty performed during the same operative episode when bone flap repair or grafting is documented.

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