CPT 61601 Resection & Reimbursement Benchmarks | OpenPayer

Summary & Overview

CPT 61601: Resection of Intradural Neoplasm, Anterior Cranial Fossa with Dural Repair

CPT code 61601 represents surgical resection of an intradural vascular or infectious neoplasm at the base of the anterior cranial fossa, with repair of any dural tear with or without graft. This neurosurgical procedure is clinically significant because it addresses lesions in a high-risk intracranial location where both lesion control and dural integrity affect neurologic outcomes. Nationally, accurate coding for complex cranial tumor resections is important for surgical quality tracking, resource planning, and payer reimbursement.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, typical payer considerations, and guidance on what the publication addresses: benchmark metrics, recent policy updates affecting coverage and prior authorization, and clinical documentation elements that support correct coding. The report summarizes expected sites of service and the procedural scope tied to 61601, highlights common payer coverage patterns, and identifies gaps where Data not available in the input prevents further specification. This national-level summary is designed for revenue cycle leaders, neurosurgeons, and policy analysts seeking a focused reference on coding and coverage considerations for anterior cranial fossa intradural neoplasm resections with dural repair.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 61601neurosurgeryintracranial tumor resectiondural repairoperative codinghospital inpatientoperating roomsurgical oncology

Billing Code Overview

CPT code 61601 describes surgical removal of a portion or all of an intradural vascular or infectious neoplasm at the base of the anterior cranial fossa, with repair of any dural tear with or without a graft. This procedure involves intracranial neurosurgical resection of neoplastic tissue located intradurally along the anterior cranial base and includes dural repair when performed.

Service type: Neurosurgical intracranial tumor resection with dural repair
Typical site of service: Inpatient or outpatient hospital operating room, typically within a neurosurgery service or tertiary care surgical center

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient presents with progressive frontal headaches, anosmia, and new-onset seizures. Neuroimaging (MRI with contrast) demonstrates an enhancing intradural mass arising from the anterior cranial fossa floor consistent with a dural-based vascular neoplasm (e.g., meningioma) with concern for dural invasion and cerebrospinal fluid (CSF) leak risk. The neurosurgery team schedules operative resection with the intent to remove part or all of the intradural neoplasm and to repair any dural defect. The clinical workflow includes preoperative consent and imaging review, stereotactic navigation planning, general anesthesia, craniotomy or extended frontal approach to access the anterior cranial fossa, microsurgical resection of the tumor, inspection for dural tears, and primary dural repair or placement of a dural graft as needed. Intraoperative neurophysiologic monitoring and vascular control techniques are available if the lesion is vascular. Postoperative care includes neurosurgical intensive monitoring, postoperative imaging to assess extent of resection and rule out complications (hematoma, residual tumor, CSF leak), and coordination with radiation oncology if adjuvant therapy is indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard reporting	Use when no other modifier applies and the service is submitted as normally performed.

CPT 61600: Surgical Excision of Lesions at Anterior Cranial Fossa Base

Taxonomy Code	Specialty	Notes
`207SG0200X`	Neurological Surgery	Primary specialty performing `61601` for intradural anterior cranial fossa lesions.
`207XS0102X`	Otolaryngology - Head & Neck Surgery	May participate when anterior cranial fossa access or endoscopic endonasal approaches are used.
`208000000X`	Surgery	General surgical oversight or in settings with combined craniofacial approaches.
`2084P0800X`	Plastic and Reconstructive Surgery	Participates for complex cranial base reconstruction and soft tissue/graft management.
`207Q00000X`	Vascular Surgery	Consulted when significant vascular involvement requires vascular expertise.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D32.0`	Benign neoplasm of cerebral meninges	Common dural-based tumor (meningioma) of the anterior cranial fossa indicating resection and possible dural repair.
`C71.0`	Malignant neoplasm of frontal lobe	Invasive intradural lesions near the anterior cranial fossa floor that may require resection.
`G93.0`	Cerebral edema	Associated perioperative condition requiring management during and after resection.
`G40.909`	Epilepsy, unspecified, not intractable, without status epilepticus	Seizures are a common presenting symptom prompting surgical intervention for anterior cranial fossa lesions.
`S06.5X9A`	Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter	Included as a potential concurrent intradural pathology necessitating repair and exploration in acute settings.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61582`	Craniectomy or craniotomy for access to anterior skull base (extensive)	May be performed to gain exposure for resection of anterior cranial fossa intradural neoplasms prior to `61601`.
`62187`	Decompression of skull base lesion; anterior cranial fossa	Used for additional decompression procedures in the same operative session when indicated.
`69714`	Repair of dural defect, craniotomy (duraplasty)	Used when specific dural grafting or complex dural reconstruction is performed in conjunction with tumor removal.
`61790`	Stereotactic radiosurgical ablation, cranial lesion	May be used postoperatively as adjuvant therapy for residual tumor not amenable to resection.
`95920`	Intraoperative neurophysiology monitoring, each monitoring modality	Used during resection of vascular or invasive anterior cranial fossa tumors to monitor neural function.
`70553`	MRI brain with and without contrast	Preoperative or postoperative imaging commonly performed to plan and evaluate extent of resection.

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