Medicare Benefits Schedule - Note TN.8.70

The surgical management of lesions involving the skull base (base of anterior, middle and posterior fossae) often requires the skills of several surgeons or a number of surgeons from different surgical specialties working together or in tandem during the operative session. These operations are usually not staged because of the need for definitive closure of the dura, subcutaneous tissues, and skin to avoid serious infections such as osteomyelitis and/or meningitis. 

Items 39638 to 39656 cover the removal of the tumour, which would normally be performed by a neurosurgeon or an otolaryngology surgeon. Other items are available to cover procedures performed as a part of skull base surgery by practitioners in other specialities, such as plastic and reconstructive surgery.

Related Items: 39638 39639 39641 39651 39654 39656

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Multiple Operation Rule

Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, principal surgeon

(Anaes.) (Assist.)

Fee: $4,685.80 Benefit: 75% = $3,514.35

(See para TN.8.70 of explanatory notes to this Category)

Multiple Operation Rule

Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, co‑surgeon

(Assist.)

Fee: $3,744.50 Benefit: 75% = $2,808.40

(See para TN.8.70 of explanatory notes to this Category)

Multiple Operation Rule

Anterior or middle cranial fossa or cavernous sinus, tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty - one surgeon

(Anaes.) (Assist.)

Fee: $4,942.40 Benefit: 75% = $3,706.80

(See para TN.8.70 of explanatory notes to this Category)

Multiple Operation Rule

Petro-clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty - one surgeon

(Anaes.) (Assist.)

Fee: $6,097.70 Benefit: 75% = $4,573.30

(See para TN.8.70 of explanatory notes to this Category)

Multiple Operation Rule

Petro-clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, principal surgeon

(Anaes.) (Assist.)

Fee: $4,685.80 Benefit: 75% = $3,514.35

(See para TN.8.70 of explanatory notes to this Category)

Multiple Operation Rule

Petro clival, clival or foramen magnum tumour or vascular lesion, removal or radical excision of, including stereotaxy and cranioplasty—conjoint surgery, co surgeon

(Assist.)

Fee: $3,744.50 Benefit: 75% = $2,808.40

(See para TN.8.70 of explanatory notes to this Category)