CPT code 61591 represents a complex neurosurgical approach to the middle cranial fossa using an infratemporal, preauricular (transparotid) corridor to expose skull-base lesions or defects. The technique is used to access lesions involving the petrous apex, auditory canal, sigmoid sinus, or adjacent skull-base structures and can include ancillary procedures such as mastoidectomy or sigmoid sinus resection. Nationally, this code captures high-complexity skull-base surgery performed primarily at tertiary hospitals and specialized surgical centers.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, the typical settings where it is performed, and the practical billing considerations tied to a high-complexity cranial base approach. The publication outlines benchmarks for utilization and payment trends, identifies common documentation and coding touchpoints relevant to surgical teams and billing staff, and summarizes policy updates that affect hospital-based surgical reimbursement for complex skull-base procedures.

This summary is intended for national audiences including neurosurgeons, otolaryngologists, hospital administrators, and revenue cycle professionals who need a focused reference on procedural intent, setting, and payer coverage landscape for CPT code 61591.