CPT 61750 Reimbursement & Policy Benchmarks

CPT code 61750 denotes an image-guided neurosurgical procedure in which part of the skull is removed and an intracranial lesion is biopsied, aspirated, or excised using coordinates mapped from CT and/or MRI. This code captures complex, operating-room–based care involving neurosurgical planning and stereotactic localization. Nationally, accurate coding for this procedure affects clinical documentation, facility and professional reimbursement, and tracking of neurosurgical case mix and outcomes.

Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for 61750, typical sites of service, and the payer mix commonly responsible for coverage decisions. The publication summarizes benchmarks and coding considerations, highlights policy updates that commonly affect authorization and bundling, and provides clinical context relevant to coding and billing teams.

This material is intended for billing managers, neurosurgical clinicians involved in documentation, revenue cycle staff, and policy analysts who need a clear, national-level summary of the code, its clinical use, and the payer environment. Data not available in the input is noted where relevant.

Billing Code Overview

CPT code 61750 describes a neurosurgical procedure in which the provider removes a portion of skull bone (craniotomy) and biopsies, aspirates, and/or excises an intracranial lesion using mapped coordinates derived from computed tomography (CT) and/or magnetic resonance imaging (MRI) to identify the target lesion. This procedure is an image-guided intracranial biopsy or excision performed with stereotactic localization.

Service type: Image-guided neurosurgical intracranial lesion biopsy/excision
Typical site of service: Hospital operating room or specialized ambulatory surgical center with neurosurgical and neuroradiology capabilities

Clinical Context

A 58-year-old male presents with progressive left-sided weakness and new-onset seizures. MRI brain demonstrates a 2.5 cm enhancing lesion in the right frontal lobe suspicious for primary glioma or metastasis. After multidisciplinary review, the neurosurgeon schedules a stereotactic craniotomy with image-guided biopsy and partial resection. Preoperative workup includes CT and MRI with stereotactic planning, anesthesia evaluation, and informed consent discussing risks of hemorrhage, infection, and neurologic deficit. In the operating room, the surgeon obtains CT/MRI-mapped coordinates, creates a craniotomy, and uses the stereotactic guidance system to localize and biopsy and partially excise the intracranial lesion. Specimens are sent to pathology. Immediate postoperative CT confirms resection extent, and the patient is transferred to a neurosurgical step-down unit for neurologic monitoring and postoperative imaging.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical complexity substantially exceeds the usual for `61750`.
`23`	Unusual anesthesia

Taxonomy Code	Specialty	Notes
`207V00000X`	Neurological Surgery	Primary specialty performing stereotactic craniotomy and biopsy/excision.
`2073P0800X`	Neurosurgery - Pediatric	Pediatric neurosurgeons for stereotactic intracranial procedures in children.
`2084P0800X`	Vascular Neurology	May be involved when vascular lesions or endovascular considerations exist.
`207G00000X`	Pain Medicine / Neurology	Stereotactic procedures occasionally coordinated with neurologists for functional lesions.
`208D00000X`	Diagnostic Radiology	Radiologists assist with image guidance planning and intraoperative imaging.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C71.9`	Malignant neoplasm of brain, unspecified	Primary brain tumor suspected or confirmed; common indication for stereotactic biopsy/excision.
`C79.31`	Secondary malignant neoplasm of brain	Metastatic brain lesion requiring biopsy or resection for diagnosis or symptom control.
`D33.9`	Benign neoplasm of brain, unspecified	Suspected low-grade tumor where tissue diagnosis guides management.
`G93.1`	Anoxic brain damage, not elsewhere classified	Post-injury mass lesions or cystic changes may require surgical evaluation with stereotactic techniques.
`R56.9`	Unspecified convulsions	New-onset seizures from an intracranial lesion prompting diagnostic biopsy/resection with `61750`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`61620`	Stereotactic resection or excision of intracranial lesion; supratentorial	Alternative stereotactic code for stereotactic intracranial lesion resection depending on anatomic approach and extent; may be used when resection rather than biopsy is performed.
`69990`	Microsurgical techniques, requiring use of operating microscope (list separately in addition to primary procedure)	Often billed in conjunction with `61750` when an operating microscope is used for microsurgical dissection during biopsy or excision.
`77012`	CT guidance for needle placement (diagnostic)	Used when CT imaging guidance is separately reported for localization or biopsy planning supporting `61750`.
`95920`	Cortical mapping and monitoring (intraoperative neurophysiology)	Used when intraoperative neurophysiologic monitoring (motor/sensory mapping) is performed to reduce neurologic risk during `61750`.
`88305`	Pathology, surgical pathology, gross and microscopic examination	Used for processing and reporting of biopsy specimens obtained during `61750`.

OpenPayer

Summary & Overview

CPT 61750: Image-Guided Intracranial Lesion Biopsy or Excision