Summary & Overview
CPT 61518: Craniectomy for Infratentorial/Posterior Fossa Brain Tumor Excision
CPT 61518 denotes a neurosurgical craniectomy performed to excise infratentorial or posterior fossa brain tumors, excluding meningiomas, cerebellopontine angle tumors, and midline skull-base lesions. Nationally, this code captures high-acuity operative management of posterior fossa neoplasms where surgical access via skull removal is required. It matters because it reflects complex operative work, resource-intensive perioperative care, and potential implications for hospital and surgeon billing across payers.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical context of the procedure, guidance on typical sites of service, and mention of common billing modifiers and related CPTs for situational coding clarity. The publication highlights coding boundaries (which tumor types are excluded under this descriptor), common ICD-10 diagnoses that may support use of the code, and adjacent codes that clinicians and coders may need to consider when selecting the appropriate operative code.
This summary serves clinicians, coding professionals, and payers seeking a clear, national-level reference on what CPT 61518 represents, where it is typically performed, and what coding considerations and related codes are commonly associated with infratentorial/posterior fossa tumor excision.
CPT Code Overview
CPT 61518 describes a craniectomy for excision of a brain tumor located in the infratentorial or posterior fossa, excluding procedures for meningioma, cerebellopontine angle tumors, or midline tumors at the base of the skull. The procedure is performed by neurosurgeons and involves removal of part of the skull to access and excise the specified intracranial tumor.
Service type: Neurosurgery
Typical site of service: Hospital inpatient or outpatient surgical setting (for example, POS 21 or 22)
Clinical & Coding Specifications
Clinical Context
A patient presents with symptoms such as progressive headache, cerebellar ataxia, cranial nerve deficits, or new focal neurologic signs consistent with a posterior fossa or infratentorial mass. Imaging (MRI with contrast) demonstrates an infratentorial/posterior fossa intra-axial lesion suspicious for primary or metastatic neoplasm or a compressive lesion producing brainstem or cerebellar compression. Neurosurgery evaluates the patient and schedules a craniectomy for resection of the tumor via a posterior fossa approach. The procedure typically occurs in a hospital inpatient or outpatient surgical setting, with preoperative consent, intraoperative neuromonitoring as indicated, general endotracheal anesthesia, and postoperative admission for neurologic observation and imaging. Pathology specimens are sent for histologic diagnosis and postoperative care includes monitoring for increased intracranial pressure, cranial nerve function, and rehabilitation needs.
Coding Specifications
Modifier 62 - Two Surgeons
- Use when two surgeons with distinct responsibilities perform portions of the same operative session, each contributing specialized skills.
Modifier 80 - Assistant Surgeon
- Use when an assistant surgeon is documented as providing surgical assistance during the procedure.
Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
207T00000X | Neurological Surgery |
208600000X | Surgery |
207ZP0102X | Pediatric Neurosurgery |
- These taxonomies identify the appropriate surgical specialties typically performing or involved in
61518.
Related Diagnoses
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C71.9— Malignant neoplasm of brain, unspecified- Clinical relevance: Malignant primary brain tumors in the posterior fossa may require surgical resection via an infratentorial craniectomy for diagnosis and cytoreduction.
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D33.0— Benign neoplasm of brain, supratentorial- Clinical relevance: Although listed as supratentorial, benign brain neoplasms may have analogous presentations; relevance for surgical planning is tumor histology and location determining the use of craniectomy.
-
D43.0— Neoplasm of uncertain behavior of brain, supratentorial- Clinical relevance: Lesions of uncertain behavior may require resection to establish diagnosis and relieve mass effect; operative management considerations overlap with those for
61518when infratentorial involvement is present.
- Clinical relevance: Lesions of uncertain behavior may require resection to establish diagnosis and relieve mass effect; operative management considerations overlap with those for
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G93.5— Compression of brain- Clinical relevance: Posterior fossa masses causing brain compression may necessitate surgical decompression and tumor excision using an infratentorial craniectomy approach.
-
R47.01— Aphasia- Clinical relevance: New or worsening neurologic deficits such as aphasia may indicate a mass effect or tumor involvement requiring neurosurgical evaluation and possible resection; correlation with lesion location is required.
Related CPT Codes
| CPT Code | Description |
|---|---|
61519 | Craniectomy for excision of tumor of meninges, infratentorial or posterior fossa |
61526 | Data not available in the input. |
-
61519is a related posterior fossa craniectomy code specific to meningeal tumors and is used when the lesion arises from the meninges rather than intra-axial brain parenchyma; it serves as an alternative code when the tumor origin matches that description. -
61526: Data not available in the input. -
These codes may be considered as alternatives to
61518depending on tumor origin and operative findings; they are not typically reported together for the same lesion.
National Reimbursement Benchmarks
Medicare mean allowed rate ($2,682.83) is modestly lower than the BUCA (combined commercial) mean ($3,592.70), reflecting that average commercial payments nationally exceed Medicare for 61518. The gap between Medicare and the highest commercial payer, UnitedHealth Group ($5,017.64), is substantial, indicating material uplifts in commercial contracts relative to Medicare.
Dispersion measured as the interquartile range (P75 − P25) varies across payers. UnitedHealth Group shows one of the widest spreads (P75−P25 = $2,900.00), followed by Cigna ($2,606.00) and Blue Cross Blue Shield ($1,854.00). Medicare exhibits the tightest dispersion ($278.00), indicating more consistency across localities. The table and chart below present the full percentile and mean-rate breakdown for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.