CPT code 61781: Cranial navigation, intradural2026 Medicare rate & RVUs in California
Reports computer-assisted navigation used during cranial surgery involving an intradural target, as an add-on to the primary procedure.
CMS doesn’t publish an office rate for 61781 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 61781 covers
This add-on covers computer-assisted guidance used during cranial surgery when the operative target or path is intradural. The surgeon uses preoperative imaging registered to the patient and navigation equipment to orient instruments during the operation. Neurosurgeons most often use it in an operating room for procedures such as intracranial tumor surgery or placement of brain electrodes when navigation guides work within the dura.
Report 61781 with the eligible primary cranial procedure, not by itself. The operative record should support use of navigation for the intradural work, including the imaging and its intraoperative use. Distinguish it from navigation for an extradural cranial target or spinal procedure. CMS classifies it as an add-on: it is billed only with a primary procedure, and its payment is within that procedure’s global period.
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.
Where 61781 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $201.78 |
| Chico, CA | Unavailable | $197.85 |
| El Centro, CA | Unavailable | $198.10 |
| Fresno, CA | Unavailable | $197.85 |
| Hanford, CA | Unavailable | $197.85 |
| Los Angeles, CA | Unavailable | $210.93 |
| Madera, CA | Unavailable | $197.85 |
| Marin County, CA | Unavailable | $216.82 |
| Merced, CA | Unavailable | $197.85 |
| Modesto, CA | Unavailable | $197.85 |
| Napa, CA | Unavailable | $211.48 |
| Oxnard, CA | Unavailable | $207.23 |
| Redding, CA | Unavailable | $197.85 |
| Rest of California | Unavailable | $197.85 |
| Riverside, CA | Unavailable | $213.96 |
| Sacramento, CA | Unavailable | $203.02 |
| Salinas, CA | Unavailable | $202.23 |
| San Benito County, CA | Unavailable | $223.90 |
| San Diego, CA | Unavailable | $203.98 |
| San Francisco, CA | Unavailable | $215.11 |
| San Luis Obispo, CA | Unavailable | $199.67 |
| Santa Clara County, CA | Unavailable | $216.89 |
| Santa Cruz, CA | Unavailable | $203.39 |
| Santa Maria, CA | Unavailable | $202.16 |
| Santa Rosa, CA | Unavailable | $205.04 |
| Stockton, CA | Unavailable | $197.85 |
| Vallejo, CA | Unavailable | $209.01 |
| Visalia, CA | Unavailable | $197.85 |
| Yuba City, CA | Unavailable | $197.85 |
How the 61781 rate is calculated
Each of 61781’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 · 61781
RVUs × geographic indexes × conversion factor
Work3.66
3.66 RVUs× 1.000 GPCI
Practice expense1.27
1.27 RVUs× 1.000 GPCI
Malpractice1.51
1.51 RVUs× 1.000 GPCI
Adjusted RVUs
6.4400
Conversion factor
$33.4009
Medicare rate
$215.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61781
The CMS indicators that decide how 61781 is paid alongside other services.
CMS payment indicators · 61781
Cranial navigation, intradural
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
61781 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61782Cranial navigationExtradural
- Use 61781 for navigation involving an intradural cranial target; 61782 is for extradural cranial work.
- 61783Spinal navigationComputer-assisted guidance
- 61783 applies to spinal navigation. 61781 is for navigation during cranial intradural procedures.
- 61751Brain biopsyCT/MR-guided stereotactic
- 61751 describes an intracranial biopsy service using CT or MR guidance. 61781 is an add-on for computer-assisted navigation during a qualifying cranial intradural procedure.
61781 billing questions
How does 61781 differ from 61782?
61781 is for navigation during cranial work involving an intradural target. 61782 is the related cranial navigation code for an extradural target.
Can 61781 be reported by itself?
No. It is an add-on and must be reported with an eligible primary procedure.
What documentation supports reporting 61781?
The operative record should identify the intradural work and document that computer-assisted navigation was used to guide the procedure.
Is 61781 a professional or technical component?
CMS classifies 61781 as an add-on code and does not identify separate professional or technical components.
How does 61781 differ from 61751?
61751 describes an intracranial biopsy service using CT or MR guidance. 61781 is an add-on for computer-assisted navigation during a qualifying cranial intradural procedure.
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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