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CPT 61682: Craniotomy for Resection of Complex Supratentorial AVM

CPT code 61682 denotes a neurosurgical craniotomy for resection of a complex supratentorial arteriovenous malformation (AVM). This code applies to operative treatment of AVMs larger than 3 cm or those with deep venous drainage or involvement of eloquent cortex areas such as sensorimotor, speech, or language regions. The code is clinically significant because it represents high-risk, resource-intensive neurosurgical care with implications for hospital resource use, postoperative monitoring, and specialty reimbursement.

Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview useful to hospital administrators, neurosurgeons, and billing professionals.

Readers will find: an explanation of the clinical context and surgical scope for 61682; typical sites of service and service type; common modifier practice and billing considerations summarized from input; and what information is available or missing for taxonomies, diagnoses, and related codes. The piece frames 61682 within national payer coverage patterns and operational implications without state-specific detail, offering concise context for clinical coding and administrative planning.

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Billing Code Overview

CPT code 61682 describes a neurosurgical procedure that involves craniotomy with resection of a complex supratentorial arteriovenous malformation (AVM). The procedure removes a portion of the skull (craniotomy) to access and excise an AVM located in the supratentorial region of the brain — the area above the tentorium cerebelli that includes the cerebral hemispheres.

Service type: Neurosurgical operative procedure for complex intracranial AVM resection.

Typical site of service: Inpatient hospital operating room with postoperative inpatient care, given the complexity and intracranial nature of the procedure.

Data not available in the input for Associated Taxonomies, ICD-10 Diagnoses, and Related Codes.

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CPT 61682: Craniotomy for Resection of Complex Supratentorial AVM

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Sign up for cpt 61682 policy alerts

Get alerted when payer policies referencing 61682 are released or updated.

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Billing Code Overview

Service type: Neurosurgical operative procedure for complex intracranial AVM resection.

Typical site of service: Inpatient hospital operating room with postoperative inpatient care, given the complexity and intracranial nature of the procedure.

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 38-year-old adult presenting with progressive headaches, focal seizures, or new focal neurologic deficits. Neuroimaging with MRI and cerebral angiography demonstrates a complex supratentorial arteriovenous malformation (AVM) greater than 3 cm in maximal diameter with deep venous drainage and cortical involvement near eloquent language or motor cortex. The multidisciplinary workflow includes evaluation by neurosurgery and neurointerventional teams, preoperative angiography for detailed vascular anatomy, discussion at a cerebrovascular conference, and planning for microsurgical resection. On the day of surgery the patient undergoes general endotracheal anesthesia, neuronavigation and intraoperative neuromonitoring are used because of proximity to eloquent cortex, a craniotomy is performed, and the AVM nidus is circumferentially dissected and resected with microsurgical techniques and hemostatic measures. Postoperative care involves ICU-level neurologic monitoring, repeat vascular imaging (CT angiography or digital subtraction angiography) to confirm complete resection, and rehabilitation as needed. Typical site of service is an inpatient hospital operating room with subsequent ICU stay for close neurologic observation.

Coding Specifications

Modifier	Description	When to Use
`11`	Office or other outpatient visit for the evaluation and management service as the usual way to report an encounter	Use when routine billing for the primary service is required and no unusual circumstances apply.
`22`	Increased procedural services	Use when intraoperative complexity or unusually prolonged operative time significantly increases resource use beyond usual expectations.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated but required due to the patients condition or when unexpected anesthesia circumstances occur.
`26`	Professional component	Use when reporting only the surgeons professional component separate from hospital technical charges, if applicable in billing splits.
`50`	Bilateral procedure	Rare for supratentorial AVM resection but use if bilateral craniotomies and resections are performed and payer requires bilateral reporting.
`51`	Multiple procedures	Use when additional distinct surgical procedures are performed during the same operative session (when payer requires modifier reporting).
`52`	Reduced services	Use when the planned procedure is partially reduced or not completed as documented (e.g., aborted resection).
`53`	Discontinued procedure	Use when the operation is terminated prior to completion for patient-related or intraoperative safety reasons.
`62`	Two surgeons	Use when two surgeons (co-surgeons) of different specialties share responsibility for the procedure and both provide significant portions of the work.
`78`	Unplanned return to the operating room	Use for related staged or corrective procedures when the patient returns to the OR within the postoperative global period for a related reason.
`80`	Assistant surgeon	Use when an assistant surgeon provides assistance; some payers require separate reporting.
`81`	Minimum assistant surgeon	Use when only a minimum level of assistance is provided by a qualified assistant.
`82`	Assistant surgeon (when a qualified resident surgeon is unavailable)	Use when an assistant is used because no qualified resident is available.
`58`	Staged or related procedure during the postoperative period	Use when a planned staged resection or related procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing microsurgical AVM resection.
207RG0100X	Neurological Surgery (Neurosurgeon)	Alternate taxonomy designation for neurosurgeons.
2084N0400X	Neurocritical Care	Physicians providing postoperative ICU management.
207K00000X	Neurology	Pre- and postoperative neurologic evaluation, seizure management and follow-up.
2086S0122X	Vascular Neurology / Endovascular Neurosurgery	Specialists involved in preoperative angiography or hybrid procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I60.9`	Nontraumatic subarachnoid hemorrhage, unspecified	AVM rupture can present as nontraumatic subarachnoid hemorrhage prompting urgent resection.
`I61.9`	Nontraumatic intracerebral hemorrhage, unspecified	Intracerebral hemorrhage from AVM rupture is a common indication for surgical treatment.
`Q28.2`	Arteriovenous malformation of cerebral vessels	Primary diagnostic code describing the AVM targeted by resection.
`G40.909`	Epilepsy, unspecified, not intractable, without status epilepticus	AVM-related seizures are an indication for definitive surgical management in select patients.
`R51`	Headache	Symptomatic AVMs may present with refractory headaches leading to evaluation and treatment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61680`	Craniectomy or craniotomy for excision of cerebral AVM, supratentorial, 3 cm or less	Used for smaller supratentorial AVMs; represents a less extensive resection code when lesion size is ≤ 3 cm.
`61716`	Stereotactic localization for preoperative or intraoperative use, may include imaging and guidance	Used for neuronavigation and stereotactic localization to guide safe resection near eloquent cortex.
`61684`	Craniectomy or craniotomy for excision of cerebral AVM, infratentorial	Related when AVM is located below the tentorium; differentiates anatomical site.
`61790`	Insertion of intracranial monitoring device (e.g., for neuromonitoring)	Used when intraoperative or ICU intracranial monitoring devices are placed for patient management.
`36224`	Selective catheter angiography, cerebral, unilateral or bilateral, with superselective catheterization	Used in preoperative diagnostic or intraoperative angiography to delineate AVM arterial feeders and venous drainage.

CPT 61680: Craniotomy with Resection of Supratentorial AVM

CPT-61684-INFRATENTORIAL-AVM-RESECTION-SMALL-ACCESSIBLE

CPT 61684: Resection of Small Infratentorial Arteriovenous Malformation

CPT-61686-INFRATENTORIAL-AVM-RESECTION-COMPLEX

CPT 61686: Resection of Complex Infratentorial Arteriovenous Malformation

CPT-61690-DURAL-AVM-RESECTION-CRANIECTOMY

CPT 61690: Craniectomy and Resection of Simple Dural Arteriovenous Malformation

CPT-61692-COMPLEX-DURAL-AVM-RESECTION-CRANIOTOMY

CPT 61692: Resection of Complex Dural Arteriovenous Malformation

CPT-61697-INTRACRANIAL-ANEURYSM-REPAIR-INTERNAL-CAROTID

CPT 61697: Intracranial Aneurysm Repair, Internal Carotid Circulation

CPT-61698-INTRACRANIAL-VERTEBROBASILAR-ANEURYSM-REPAIR

CPT 61698: Intracranial Vertebrobasilar Aneurysm Repair

CPT-61700-INTRACRANIAL-ANEURYSM-REPAIR-INTERNAL-CAROTID-CIRCULATION

CPT 61700: Intracranial Aneurysm Repair, Internal Carotid Circulation

CPT-61702-INTRACRANIAL-ANEURYSM-SURGICAL-REPAIR-VERTEBROBASILAR

CPT 61702: Intracranial Aneurysm Surgical Repair, Vertebrobasilar

CPT-61703-INTRACRANIAL-ANEURYSM-CLIPPING-WITH-CAROTID-CONTROL

CPT 61703: Intracranial Aneurysm Clipping with Carotid Control

Showing 1–10 of 14

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Office or other outpatient visit for the evaluation and management service as the usual way to report an encounter	Use when routine billing for the primary service is required and no unusual circumstances apply.
`22`	Increased procedural services	Use when intraoperative complexity or unusually prolonged operative time significantly increases resource use beyond usual expectations.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated but required due to the patients condition or when unexpected anesthesia circumstances occur.
`26`	Professional component	Use when reporting only the surgeons professional component separate from hospital technical charges, if applicable in billing splits.
`50`	Bilateral procedure	Rare for supratentorial AVM resection but use if bilateral craniotomies and resections are performed and payer requires bilateral reporting.
`51`	Multiple procedures	Use when additional distinct surgical procedures are performed during the same operative session (when payer requires modifier reporting).
`52`	Reduced services	Use when the planned procedure is partially reduced or not completed as documented (e.g., aborted resection).
`53`	Discontinued procedure	Use when the operation is terminated prior to completion for patient-related or intraoperative safety reasons.
`62`	Two surgeons	Use when two surgeons (co-surgeons) of different specialties share responsibility for the procedure and both provide significant portions of the work.
`78`	Unplanned return to the operating room	Use for related staged or corrective procedures when the patient returns to the OR within the postoperative global period for a related reason.
`80`	Assistant surgeon	Use when an assistant surgeon provides assistance; some payers require separate reporting.
`81`	Minimum assistant surgeon	Use when only a minimum level of assistance is provided by a qualified assistant.
`82`	Assistant surgeon (when a qualified resident surgeon is unavailable)	Use when an assistant is used because no qualified resident is available.
`58`	Staged or related procedure during the postoperative period	Use when a planned staged resection or related procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
2084P0800X	Neurosurgery	Primary specialty performing microsurgical AVM resection.
207RG0100X	Neurological Surgery (Neurosurgeon)	Alternate taxonomy designation for neurosurgeons.
2084N0400X	Neurocritical Care	Physicians providing postoperative ICU management.
207K00000X	Neurology	Pre- and postoperative neurologic evaluation, seizure management and follow-up.
2086S0122X	Vascular Neurology / Endovascular Neurosurgery	Specialists involved in preoperative angiography or hybrid procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I60.9`	Nontraumatic subarachnoid hemorrhage, unspecified	AVM rupture can present as nontraumatic subarachnoid hemorrhage prompting urgent resection.
`I61.9`	Nontraumatic intracerebral hemorrhage, unspecified	Intracerebral hemorrhage from AVM rupture is a common indication for surgical treatment.
`Q28.2`	Arteriovenous malformation of cerebral vessels	Primary diagnostic code describing the AVM targeted by resection.
`G40.909`	Epilepsy, unspecified, not intractable, without status epilepticus	AVM-related seizures are an indication for definitive surgical management in select patients.
`R51`	Headache	Symptomatic AVMs may present with refractory headaches leading to evaluation and treatment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61680`	Craniectomy or craniotomy for excision of cerebral AVM, supratentorial, 3 cm or less	Used for smaller supratentorial AVMs; represents a less extensive resection code when lesion size is ≤ 3 cm.
`61716`	Stereotactic localization for preoperative or intraoperative use, may include imaging and guidance	Used for neuronavigation and stereotactic localization to guide safe resection near eloquent cortex.
`61684`	Craniectomy or craniotomy for excision of cerebral AVM, infratentorial	Related when AVM is located below the tentorium; differentiates anatomical site.
`61790`	Insertion of intracranial monitoring device (e.g., for neuromonitoring)	Used when intraoperative or ICU intracranial monitoring devices are placed for patient management.
`36224`	Selective catheter angiography, cerebral, unilateral or bilateral, with superselective catheterization	Used in preoperative diagnostic or intraoperative angiography to delineate AVM arterial feeders and venous drainage.

CPT 61680: Craniotomy with Resection of Supratentorial AVM

CPT-61684-INFRATENTORIAL-AVM-RESECTION-SMALL-ACCESSIBLE

CPT 61684: Resection of Small Infratentorial Arteriovenous Malformation

CPT-61686-INFRATENTORIAL-AVM-RESECTION-COMPLEX

CPT 61686: Resection of Complex Infratentorial Arteriovenous Malformation

CPT-61690-DURAL-AVM-RESECTION-CRANIECTOMY

CPT 61690: Craniectomy and Resection of Simple Dural Arteriovenous Malformation

CPT-61692-COMPLEX-DURAL-AVM-RESECTION-CRANIOTOMY

CPT 61692: Resection of Complex Dural Arteriovenous Malformation

CPT-61697-INTRACRANIAL-ANEURYSM-REPAIR-INTERNAL-CAROTID

CPT 61697: Intracranial Aneurysm Repair, Internal Carotid Circulation

CPT-61698-INTRACRANIAL-VERTEBROBASILAR-ANEURYSM-REPAIR

CPT 61698: Intracranial Vertebrobasilar Aneurysm Repair

CPT-61700-INTRACRANIAL-ANEURYSM-REPAIR-INTERNAL-CAROTID-CIRCULATION

CPT 61700: Intracranial Aneurysm Repair, Internal Carotid Circulation

CPT-61702-INTRACRANIAL-ANEURYSM-SURGICAL-REPAIR-VERTEBROBASILAR

CPT 61702: Intracranial Aneurysm Surgical Repair, Vertebrobasilar

CPT-61703-INTRACRANIAL-ANEURYSM-CLIPPING-WITH-CAROTID-CONTROL

CPT 61703: Intracranial Aneurysm Clipping with Carotid Control

Showing 1–10 of 14

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.