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The correct answer depends on the circumstances of the surgery. The surgeon may create a burr hole and use a needle to decompress a third ventricular cyst. If the cyst is near the surface of the brain (e.g., it extends above the ventricle), the best code choice is 61156 (Burr hole[s]; with aspiration of hematoma or cyst, intracerebral). When approaching through a burr hole(s) but removing the cyst by stereotactic aspiration, report 61750 (Stereotactic biopsy, aspiration, or excision, including burr hole[s], for intracranial lesion) or 61751 ( with computerized axial tomography and/or magnetic resonance imagery) as appropriate.
The cyst may also be removed via an open procedure with craniectomy. In this case, the correct code is 61516 (Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial).