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    v1.0.28
    OpenPayerBilling CodesCraniectomy or Craniotomy ProceduresCPT cpt-61538-temporal-lobectomy-with-intraoperative-ecog
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    CPT 61538: Temporal Lobectomy with Intraoperative Electrocorticography

    Medicare pays $2536 on average nationally for this procedure.

    CPT code 61538 describes a temporal lobectomy in which the provider removes the temporal lobe through an elevated skull bone and performs intraoperative electrocorticography (ECoG) to record brain electrical activity and localize seizure onset; service type: neurosurgical resection with intraoperative monitoring; typical site of service: inpatient or hospital-based operating room.

    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 28-year-old patient with medically refractory focal epilepsy localized to the temporal lobe presents for surgical evaluation after failing multiple antiseizure medications. Preoperative workup includes video-electroencephalography (vEEG), high-resolution MRI brain, neuropsychological testing, and scalp EEG suggesting unilateral temporal seizure focus. The patient is scheduled for an anterior temporal lobectomy with intraoperative electrocorticography.

    Surgical workflow: Before induction, the neurosurgery and neurophysiology teams review seizure localization data. Under general anesthesia, the surgeon performs a craniotomy over the affected temporal region, elevates the skull bone flap, and resects the epileptogenic anterior temporal lobe. Intraoperative electrocorticography (ECoG) is recorded by the neurophysiology team to identify active epileptiform cortex and guide the extent of resection. Hemostasis and closure follow, with intraoperative pathological specimens sent when indicated. Typical hospital stay is 2–5 days for monitoring and neurologic assessment. Typical site of service is an inpatient or ambulatory surgical center with neurosurgical capabilities. Service type: neurosurgical operative procedure with intraoperative neurophysiology monitoring.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    61538Craniectomy or craniotomy, temporal lobectomy; with intraoperative electrocorticography (ECoG)Primary procedure described
    95940Continuous intraoperative neurophysiology monitoring (multiple modalities), includes interpretation and reportOften performed concurrently to provide continuous monitoring beyond brief ECoG sampling
    95886Electroencephalogram; prolonged recording, inpatient (more than 24 hours)Preoperative prolonged vEEG monitoring to capture seizures for localization
    70553MRI brain, with and without contrast, for surgical planningHigh-resolution MRI used to identify structural lesions and guide resection
    88305Level IV surgical pathology, gross and microscopic examinationUsed if tissue is submitted for histopathologic diagnosis during surgery

    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…
    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…
    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…
    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…
    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…
    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…
    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…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    2086S0122XPlastic and Reconstructive Surgery PhysicianA surgeon who specializes in plastic and reconstructive surgery.
    207ZI0100XImmunopathology PhysicianA pathologist who specializes in the diagnosis of immunologic diseases.
    146E00000XCommunity ParamedicA Community Paramedic is trained in responding to a scene and arranging appointments and transportation to alternate destinations through established …
    261QD1600XDevelopmental Disabilities Clinic/CenterAn entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling …
    103G00000XClinical NeuropsychologistA clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to norma…
    207LP4000XPhysician Nutrition Specialist (Anesthesiology)A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…

    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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