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Each code comes back with the ACGME category it counts toward.
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L4-5 TLIF
Understood asTransforaminal lumbar interbody fusionNoted: L4-5 — ACGME does not code by level or side, so it doesn’t change the codes.
TLIF, posterolateral plus lumbar interbody fusion
Counts · Spinal: Thoracic/Lumbar/Sacral Instrumentation Fusion
ACGME files under Spinal: Thoracic, Lumbar, or Sacral Instrumentation, Fusion, Other · Spinal: thoracic, lumbar, or sacral instrumentation, fusion, otherYour role decides which totals move.
Temporal lobectomy for epilepsy, no ECoG
Counts · Cranial/Extracranial: Epilepsy
ACGME files under Cranial: Epilepsy · Craniotomy for epilepsy (resection, cortical grid)Add the procedure you performed
Furthest behind
Cranial/Extracranial: Epilepsy
Lead1 / 5
Short by 4
Lead + Senior3 / 10
Short by 7
A Lead case moves both totals. Senior moves Lead + Senior. Assistant moves neither.
Log a bedside EVD by itself.
EVD/Transdural Monitor Placementmin 30
External ventricular drain61107Ventricular catheter via burr hole61210
An EVD, a lumbar drain, or a shunt tap counts toward its category.
Your log keeps working after the case.
- TemplatesEditAddText phrases & triggers🦴L4-5 TLIFPrimary226332284263047🧠Craniotomy for tumor (supratentorial)Primary61510
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- Days with cases202 in the last yearMonWedFriOctNovDecJanFebMarAprMayJunJulAugSepOctCases a day12–345+
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918Cases7Busiest daySep 22 ›3.5Avg per dayon days with casesYour year, day by day
- # Lumbar microdiscectomy Single-level posterior discectomy. ## Positioning Prone on a Wilson frame.  ## Steps Confirm the level on a lateral image. ## Attending preferences Dr. A: no drain. ## Pearls Image again after the exposure.CancelReview the import1 note found. Nothing is saved until you import.Lumbar microdiscectomyLumbar microdiscectomy.mdGeneral info 1 · Equipment and set-up 3 · Steps 1 · Attending preferences 1 · Pearls 1Import 1 noteBack to reviewLumbar microdiscectomyGeneral infoSingle-level posterior discectomy.IndicationsNothing placed here.Relevant anatomyNothing placed here.Equipment and set-upHeadingPositioningProne on a Wilson frame.Photo: positioning.jpegStepsConfirm the level on a lateral image.ComplicationsNothing placed here.Attending preferencesDr. A: no drain.PearlsImage again after the exposure.Operative note templatesNothing placed here.Reflections, research, and improvementsNothing placed here.
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Oct 6Harbor GeneralDr. ReyesPGY-4Note
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DoneProgress opens on what is furthest behind.
Graded against the ACGME minimums effective July 1, 2026.
- 21 of 54 minimums metFurthest behindCranial/Extracranial: EpilepsyLead1 / 5Short by 4Lead + Senior3 / 10Short by 7Peripheral NerveLead2 / 5Short by 3Lead + Senior6 / 10Short by 4RadiosurgeryLead3 / 5Short by 2Lead + Senior10 / 10 ✓
Both totals, furthest behind first
- Total Spinal14/150 lead20/300 lead + seniorSpinal: Anterior CervicalLead2 / 15Short by 13Lead + Senior4 / 30Short by 26Spinal: Posterior CervicalLead2 / 15Short by 13Lead + Senior3 / 30Short by 27Spinal: Thoracic/Lumbar/Sacral Instrumentation FusionLead5 / 15Short by 10Lead + Senior6 / 30Short by 24
Rollups count each case once
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Neurosurgery questions
Can I prep a case before the day?
Not yet. Case prep is in development for neurosurgery. Notes and templates work today.
How long does one case take to log?
About 200 seconds by hand. A 2026 study timed 20 residents, PGY-1 to PGY-7, at one academic neurosurgery department from June to September 2025. Self-reported logging averaged 199.9 seconds per case. Confirming a case drafted from the hospital record averaged 68.4 seconds. Capnolog does not connect to a hospital record system.
How many cases do residents log by graduation?
A median of 1,600 as Lead or Senior, in a national survey of 82 neurosurgery programs. The program averages ranged from 900 to 2,250. At 199.9 seconds each, 1,600 cases come to about 89 hours of logging. From July 1, 2026, the ACGME neurosurgery minimums total 800 Senior + Lead cases and 370 Lead cases. That table removed airway management, arterial line placement, and CVP line placement from critical care, which fell from 100 required cases to 70.
Sources: Burkhardt E et al. J Neurosurg. 2024; Owolo E et al. Neurosurgery. 2026; ACGME e-Communication, June 29, 2026
How many cases never reach the ACGME log?
Almost 1 in 5 at one neurosurgery program. Over one year, 14 residents had 2,150 procedures billed and 1,749 in their ACGME case logs, 18.65% fewer. At a second academic center, 58% of the neurosurgery cases in the operating-room record appeared in the ACGME case log.
Sources: McPheeters MJ et al. Surg Neurol Int. 2017; Collins C et al. J Surg Educ. 2020
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