2025 CPT code 61682
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Nervous System Surgery Feed
Surgical resection of a complex supratentorial arteriovenous malformation (AVM).
Modifiers may be applicable depending on circumstances (e.g., 22 for increased procedural service, 51 for multiple procedures, etc.).Refer to the CPT manual and NCCI edits for appropriate modifier usage.
Surgical resection of a complex supratentorial AVM is medically necessary when there is a high risk of hemorrhage, neurological deterioration, or the AVM is symptomatic.The decision is based on clinical presentation, neuroimaging findings, and assessment of the risks and benefits of surgery compared to alternative treatments.
The neurosurgeon is responsible for all aspects of the procedure, including pre-operative planning, surgical technique, and post-operative care.Anesthesiologist and other surgical support staff are also involved.
In simple words: The doctor removes a tangled cluster of abnormal blood vessels (AVM) in the brain. This requires opening the skull, carefully separating the AVM from the brain, and then removing it. The skull is then repaired and the wound closed.
This procedure involves the surgical removal of a complex arteriovenous malformation (AVM) located in the supratentorial region of the brain.A complex AVM is defined as being larger than 3 cm, potentially involving deep venous drainage, or affecting cortical areas responsible for vital functions like sensation, speech, and language. The surgery includes craniotomy (removal of a portion of the skull bone) to access the AVM, meticulous dissection to separate the AVM from surrounding brain tissue, resection of the abnormal vessels, drainage of excess fluid or blood, dural repair, and closure of the craniotomy site using plates, wires, or sutures.
Example 1: A 45-year-old male presents with recurrent headaches and neurological deficits.Imaging reveals a large (4cm), complex supratentorial AVM with deep venous drainage and proximity to eloquent cortical areas.Surgical resection (61682) is performed to remove the AVM and prevent future hemorrhage., A 28-year-old female experiences a sudden, severe headache followed by loss of consciousness. Imaging shows a ruptured supratentorial AVM (3.5cm) with significant bleeding. Emergency surgical resection (61682) is performed to control bleeding, remove the AVM, and reduce neurological deficits., A 60-year-old male with a known, asymptomatic supratentorial AVM (5cm) exhibits progressive growth on serial imaging.Surgical resection (61682) is elected proactively to prevent a potential future rupture and its associated complications.
* Detailed history and physical examination documenting neurological symptoms.* Pre-operative neurological assessment including cognitive function tests.* Neuroimaging studies (angiography, MRI, CT) clearly demonstrating the size, location, and complexity of the AVM.* Operative report detailing the surgical approach, technique, and findings.* Post-operative neurological assessment and imaging to assess the completeness of resection.* Pathology report confirming the removal of the AVM.
** The complexity of the AVM and the surgical approach significantly influence the reimbursement and procedural time.Accurate documentation is crucial for appropriate billing.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: Information not available in provided data.Consult current CPT fee schedule for RVU values.
- Global Days: Information not available in provided data.The global period will vary depending on payer and other factors. Consult payer guidelines.
- Payment Status: Active
- Modifier TC rule: The TC (Technical Component) modifier is not applicable to 61682 as it describes the complete surgical procedure.
- Fee Schedule: Information not available in provided data.Consult historical CPT fee schedules for relevant information.
- Specialties:Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center