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    v1.0.28
    OpenPayerBilling CodesCraniectomy or Craniotomy ProceduresCPT cpt-61536-resective-epilepsy-surgery-excision-epileptogenic-focus
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    CPT 61536: Resection of Epileptogenic Focus via Craniotomy

    Medicare pays $2475 on average nationally for this procedure.

    CPT code 61536 describes a surgical resection of an epileptogenic focus performed via an elevated skull bone flap (craniotomy); the service is a neurosurgical procedure for seizure control, typically performed in an inpatient hospital operating room or specialized surgical suite under general anesthesia and involves removal of brain tissue generating seizure activity.

    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.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with medically refractory focal epilepsy localized to a cortical region (for example, mesial temporal sclerosis or a neocortical epileptogenic lesion) who has undergone comprehensive presurgical evaluation including MRI, video-EEG monitoring, and neuropsychological testing. The surgical workflow begins with preoperative planning and informed consent, followed by general anesthesia. A craniotomy is performed to elevate a skull bone flap and expose the cortex. The surgeon identifies the epileptogenic focus using intraoperative neuronavigation, electrocorticography, and direct cortical stimulation as needed, then performs a tailored cortical resection or lesionectomy to remove the seizure focus. Hemostasis is achieved, the dura and bone flap are replaced as indicated, and the patient is transferred to a neurosurgical recovery unit or intensive care unit for close neurologic monitoring and postoperative imaging and anticonvulsant management.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    61536Excision of epileptogenic focus, with elevation of skull bone flap (as described)Primary operative code describing the cortical resection or lesionectomy to remove seizure focus
    61518Craniectomy or craniotomy for excision of brain tumor, supratentorial; complicated (including use of stereotactic guidance when reported separately)May be used when concomitant tumor resection and epilepsy focus excision are performed or when additional tumor-related work is required
    61880Stereotactic computer-assisted (navigational) procedure, for tumor or lesion localization and guidanceCommonly performed adjunctively for neuronavigation to localize the epileptogenic lesion intraoperatively
    95940Continuous intraoperative neurophysiology monitoring (EEG)Used for intraoperative electrocorticography and continuous EEG monitoring during epilepsy surgery
    61520Craniectomy or craniotomy for excision of brain tumor, infratentorial or posterior fossa; complicatedMay be relevant if the epileptogenic focus is in a posterior fossa location requiring a different approach
    69990Microsurgical techniques, requiring use of an operating microscopeFrequently reported when microsurgical dissection is employed during cortical resection

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    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…
    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…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2086S0105XSurgery of the Hand (Surgery) PhysicianA surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the up…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    2084N0400XNeurology PhysicianA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    133VN1101XGerontological Nutrition Registered DietitianAn individual who is a Specialist in Gerontological Nutrition and provides nutrition care to promote quality of life and optimal health for older adul…
    204F00000XTransplant Surgery PhysicianA surgeon who specializes in transplant surgery.
    364SG0600XGerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

    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.
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