CPT code 20661: Cranial halo, four-pin application2026 Medicare rate & RVUs in New Mexico
Reports application of a four-pin cranial halo to stabilize the cervical spine, such as for selected fractures or instability requiring rigid immobilization.
In New Mexico, Medicare pays $538.43 for 20661 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 20661 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 20661 covers
An orthopedic or neurosurgical provider applies a rigid ring secured to the skull with four pins to support cervical spine immobilization. The halo may be connected to a vest or another support as part of treatment for conditions such as a cervical fracture or instability. This service is generally performed in a hospital or other procedural setting when rigid external stabilization is needed.
Select this code for the four-pin cranial halo application; the six-or-more-pin application is reported with 20664. The application code includes removal of the halo. The record should support the clinical need for rigid stabilization and the pin configuration used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How New Mexico compares for 20661
Across 109 of 109 payment localities, the facility rate for 20661 runs from $479.35 in Arkansas to $687.93 in San Benito County, CA. New Mexico pays $538.43. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$538.43
- Los Angeles, CA · California$599.89+$61.46
- Washington, DC area · District of Columbia$626.90+$88.47
- Miami, FL · Florida$656.59+$118.16
- Chicago, IL · Illinois$632.40+$93.97
- Manhattan, NY · New York$651.25+$112.82
- Alaska · Alaska$633.75+$95.32
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $487.52 |
| ArkansasArkansas | — | $479.35 |
| ArizonaArizona | — | $534.96 |
| Bakersfield, CACalifornia | — | $564.76 |
| Chico, CACalifornia | — | $560.13 |
| El Centro, CACalifornia | — | $560.42 |
| Fresno, CACalifornia | — | $560.13 |
| Hanford, CACalifornia | — | $560.13 |
| Madera, CACalifornia | — | $560.13 |
| Merced, CACalifornia | — | $560.13 |
| Modesto, CACalifornia | — | $560.13 |
| Napa, CACalifornia | — | $638.14 |
| Oxnard, CACalifornia | — | $594.93 |
| Redding, CACalifornia | — | $560.13 |
| Rest of CaliforniaCalifornia | — | $560.13 |
| Riverside, CACalifornia | — | $578.93 |
| Sacramento, CACalifornia | — | $585.05 |
| Salinas, CACalifornia | — | $582.90 |
| San Diego, CACalifornia | — | $595.04 |
| Marin County, CACalifornia | — | $670.49 |
| San Francisco, CACalifornia | — | $668.49 |
| San Benito County, CACalifornia | — | $687.93 |
| Santa Clara County, CACalifornia | — | $679.76 |
| San Luis Obispo, CACalifornia | — | $574.03 |
| Santa Cruz, CACalifornia | — | $599.29 |
| Santa Maria, CACalifornia | — | $584.65 |
| Santa Rosa, CACalifornia | — | $605.03 |
| Stockton, CACalifornia | — | $560.13 |
| Vallejo, CACalifornia | — | $635.26 |
| Visalia, CACalifornia | — | $560.13 |
| Yuba City, CACalifornia | — | $560.13 |
| ColoradoColorado | — | $563.33 |
| ConnecticutConnecticut | — | $594.12 |
| DelawareDelaware | — | $544.49 |
| Fort Lauderdale, FLFlorida | — | $605.15 |
| Rest of FloridaFlorida | — | $568.80 |
| Atlanta, GAGeorgia | — | $570.96 |
| Rest of GeorgiaGeorgia | — | $529.82 |
| Hawaii, Guam, HIHawaii | — | $573.00 |
| IowaIowa | — | $490.52 |
| IdahoIdaho | — | $496.61 |
| East St. Louis, ILIllinois | — | $587.20 |
| Rest of IllinoisIllinois | — | $558.42 |
| Suburban Chicago, ILIllinois | — | $608.76 |
| IndianaIndiana | — | $499.63 |
| KansasKansas | — | $493.26 |
| KentuckyKentucky | — | $512.57 |
| New Orleans, LALouisiana | — | $542.37 |
| Rest of LouisianaLouisiana | — | $513.80 |
| Metropolitan Boston, MAMassachusetts | — | $616.74 |
| Rest of MassachusettsMassachusetts | — | $561.40 |
| Baltimore area, MDMaryland | — | $593.73 |
| Rest of MarylandMaryland | — | $554.23 |
| Rest of MaineMaine | — | $505.37 |
| Southern Maine, MEMaine | — | $528.85 |
| Detroit, MIMichigan | — | $582.46 |
| Rest of MichiganMichigan | — | $532.91 |
| MinnesotaMinnesota | — | $521.44 |
| Metropolitan Kansas City, MOMissouri | — | $532.38 |
| Metropolitan St. Louis, MOMissouri | — | $538.05 |
| Rest of MissouriMissouri | — | $507.31 |
| MississippiMississippi | — | $493.17 |
| MontanaMontana | — | $553.34 |
| North CarolinaNorth Carolina | — | $510.57 |
| North DakotaNorth Dakota | — | $518.53 |
| NebraskaNebraska | — | $491.99 |
| New HampshireNew Hampshire | — | $559.36 |
| Northern New JerseyNew Jersey | — | $619.98 |
| Rest of New JerseyNew Jersey | — | $595.75 |
| NevadaNevada | — | $543.96 |
| NYC suburbs and Long Island, NYNew York | — | $675.91 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $604.22 |
| Queens, NYNew York | — | $649.25 |
| Rest of New YorkNew York | — | $519.83 |
| OhioOhio | — | $525.79 |
| OklahomaOklahoma | — | $505.75 |
| Portland, OROregon | — | $577.03 |
| Rest of OregonOregon | — | $534.70 |
| Metropolitan Philadelphia, PAPennsylvania | — | $581.14 |
| Rest of PennsylvaniaPennsylvania | — | $523.71 |
| Puerto RicoPuerto Rico | — | $556.13 |
| Rhode IslandRhode Island | — | $561.03 |
| South CarolinaSouth Carolina | — | $520.06 |
| South DakotaSouth Dakota | — | $514.42 |
| TennesseeTennessee | — | $496.81 |
| Austin, TXTexas | — | $565.85 |
| Beaumont, TXTexas | — | $520.18 |
| Brazoria, TXTexas | — | $538.98 |
| Dallas, TXTexas | — | $545.35 |
| Fort Worth, TXTexas | — | $542.89 |
| Galveston, TXTexas | — | $542.45 |
| Houston, TXTexas | — | $574.66 |
| Rest of TexasTexas | — | $531.26 |
| UtahUtah | — | $528.06 |
| VirginiaVirginia | — | $530.67 |
| Virgin Islands, VIUnited States Virgin Islands | — | $556.13 |
| VermontVermont | — | $521.18 |
| Rest of WashingtonWashington | — | $558.77 |
| King County, WAWashington | — | $624.66 |
| WisconsinWisconsin | — | $499.19 |
| West VirginiaWest Virginia | — | $536.43 |
| WyomingWyoming | — | $538.17 |
20661 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 20661 rate is calculated
Each of 20661’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 20661
RVUs × geographic indexes × conversion factor
Work5.13
5.13 RVUs× 1.000 GPCI
Practice expense9.68
9.68 RVUs× 1.000 GPCI
Malpractice1.76
1.76 RVUs× 1.000 GPCI
Adjusted RVUs
16.5700
Conversion factor
$33.4009
Medicare rate
$553.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,777
- Code
- 20661
- Physician work
- 5.13
- Practice expense
- 9.68
- Malpractice
- 1.76
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.13 | × 1.000 | 5.1300 |
| Practice expense | 9.68 | × 0.917 | 8.8766 |
| Malpractice | 1.76 | × 1.201 | 2.1138 |
| Total RVUs | 16.1203 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$538.43
Facility: (5.13 × 1 + 9.68 × 0.917 + 1.76 × 1.201) × $33.4009 = $538.43
Payment rules and modifiers for 20661
20661 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 20661
Cranial halo, four-pin application
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 20661
Cranial halo, four-pin application
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
20661 without 51 · national facility
$553.45
Cranial halo, four-pin application
20661-51 · Second procedure: 50%
$276.73
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 20661 has changed in New Mexico
20661 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $538.43 | RVU26D |
| 2026-07-01 | Not available in this setting | $538.43 | RVU26C |
| 2026-04-01 | Not available in this setting | $538.43 | RVU26B |
| 2026-01-01 | Not available in this setting | $538.43 | RVU26A |
| 2025-10-01 | Not available in this setting | $498.60 | RVU25D |
| 2025-07-01 | Not available in this setting | $498.60 | RVU25C |
| 2025-04-01 | Not available in this setting | $498.60 | RVU25B |
| 2025-01-01 | Not available in this setting | $498.60 | RVU25A |
| 2024-10-01 | Not available in this setting | $517.87 | RVU24D |
| 2024-07-01 | Not available in this setting | $517.87 | RVU24C |
| 2024-04-01 | Not available in this setting | $517.87 | RVU24B |
| 2024-03-09 | Not available in this setting | $517.87 | RVU24AR |
| 2024-01-01 | Not available in this setting | $509.42 | RVU24A |
| 2023-10-01 | Not available in this setting | $511.81 | RVU23D |
| 2023-07-01 | Not available in this setting | $511.81 | RVU23C |
| 2023-04-01 | Not available in this setting | $511.81 | RVU23B |
| 2023-01-01 | Not available in this setting | $511.81 | RVU23A |
| 2022-10-01 | Not available in this setting | $505.50 | RVU22D |
| 2022-07-01 | Not available in this setting | $505.50 | RVU22C |
| 2022-04-01 | Not available in this setting | $505.50 | RVU22B |
| 2022-01-01 | Not available in this setting | $505.50 | RVU22A |
| 2021-10-01 | Not available in this setting | $503.91 | RVU21D |
| 2021-07-01 | Not available in this setting | $503.91 | RVU21C |
| 2021-04-01 | Not available in this setting | $503.91 | RVU21B |
| 2021-01-01 | Not available in this setting | $503.91 | RVU21A |
| 2020-10-01 | Not available in this setting | $508.13 | RVU20D |
| 2020-07-01 | Not available in this setting | $508.13 | RVU20C |
| 2020-04-01 | Not available in this setting | $508.13 | RVU20B |
| 2020-01-01 | Not available in this setting | $508.13 | RVU20A |
| 2019-10-01 | Not available in this setting | $518.52 | RVU19D |
| 2019-07-01 | Not available in this setting | $518.52 | RVU19C |
| 2019-04-01 | Not available in this setting | $518.52 | RVU19B |
| 2019-01-01 | Not available in this setting | $518.52 | RVU19A |
| 2018-10-01 | Not available in this setting | $516.74 | RVU18D |
| 2018-07-01 | Not available in this setting | $516.74 | RVU18C |
| 2018-04-01 | Not available in this setting | $516.74 | RVU18B |
| 2018-01-01 | Not available in this setting | $516.74 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $514.47 | RVU17D |
| 2017-07-01 | Not available in this setting | $514.47 | RVU17C |
| 2017-04-01 | Not available in this setting | $514.47 | RVU17B |
| 2017-01-01 | Not available in this setting | $514.47 | RVU17A |
| 2016-10-01 | Not available in this setting | $511.53 | RVU16D |
| 2016-07-01 | Not available in this setting | $511.53 | RVU16C |
| 2016-04-01 | Not available in this setting | $511.53 | RVU16B |
| 2016-01-01 | Not available in this setting | $511.53 | RVU16A |
| 2015-10-01 | Not available in this setting | $515.37 | RVU15D |
| 2015-07-01 | Not available in this setting | $515.37 | RVU15C |
| 2015-04-01 | Not available in this setting | $512.81 | RVU15B |
| 2015-01-01 | Not available in this setting | $512.81 | RVU15A |
| 2014-10-01 | Not available in this setting | $495.81 | RVU14D |
| 2014-07-01 | Not available in this setting | $495.81 | RVU14C |
| 2014-04-01 | Not available in this setting | $495.81 | RVU14B |
| 2014-01-01 | Not available in this setting | $495.81 | RVU14A |
| 2013-10-01 | Not available in this setting | $493.60 | RVU13D |
| 2013-07-01 | Not available in this setting | $493.60 | RVU13C |
| 2013-04-01 | Not available in this setting | $493.60 | RVU13B |
| 2013-01-01 | Not available in this setting | $493.60 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
20661 billing questions
When should 20661 be selected instead of 20664?
Use 20661 for application of a four-pin cranial halo. Code 20664 describes the six-or-more-pin cranial halo application.
Is halo removal separately reported after 20661?
Removal is included in the application service reported with 20661. Code 20665 is for removal of tongs or a halo previously applied by another physician.
Can modifier 50 be used for a halo applied on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; the cranial halo application is not reported as a bilateral service.
What documentation supports reporting 20661?
Document the clinical reason for rigid cranial stabilization, the application performed, and the four-pin configuration. The record should distinguish this service from a halo using six or more pins.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Other procedures performed in the same session are subject to the standard multiple-procedure payment reduction.
Can an assistant or co-surgeon be billed for this procedure?
Assistant-at-surgery payment is restricted for 20661. CMS does not permit co-surgeon or team-surgery billing for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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