CPT code 61781: Cranial navigation, intradural2026 Medicare rate & RVUs in Puerto Rico
Reports computer-assisted navigation used during cranial surgery involving an intradural target, as an add-on to the primary procedure.
In Puerto Rico, Medicare pays $214.81 for 61781 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 61781 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 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.
How Puerto Rico compares for 61781
Across 109 of 109 payment localities, the facility rate for 61781 runs from $178.42 in Wisconsin to $293.96 in Miami, FL. Puerto Rico pays $214.81. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$214.81
- Los Angeles, CA · California$210.93−$3.88
- Washington, DC area · District of Columbia$234.95+$20.14
- Miami, FL · Florida$293.96+$79.15
- Chicago, IL · Illinois$281.48+$66.67
- Manhattan, NY · New York$259.35+$44.54
- Alaska · Alaska$256.34+$41.53
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $187.91 |
| ArkansasArkansas | — | $184.66 |
| ArizonaArizona | — | $206.52 |
| Bakersfield, CACalifornia | — | $201.78 |
| Chico, CACalifornia | — | $197.85 |
| El Centro, CACalifornia | — | $198.10 |
| Fresno, CACalifornia | — | $197.85 |
| Hanford, CACalifornia | — | $197.85 |
| Madera, CACalifornia | — | $197.85 |
| Merced, CACalifornia | — | $197.85 |
| Modesto, CACalifornia | — | $197.85 |
| Napa, CACalifornia | — | $211.48 |
| Oxnard, CACalifornia | — | $207.23 |
| Redding, CACalifornia | — | $197.85 |
| Rest of CaliforniaCalifornia | — | $197.85 |
| Riverside, CACalifornia | — | $213.96 |
| Sacramento, CACalifornia | — | $203.02 |
| Salinas, CACalifornia | — | $202.23 |
| San Diego, CACalifornia | — | $203.98 |
| Marin County, CACalifornia | — | $216.82 |
| San Francisco, CACalifornia | — | $215.11 |
| San Benito County, CACalifornia | — | $223.90 |
| Santa Clara County, CACalifornia | — | $216.89 |
| San Luis Obispo, CACalifornia | — | $199.67 |
| Santa Cruz, CACalifornia | — | $203.39 |
| Santa Maria, CACalifornia | — | $202.16 |
| Santa Rosa, CACalifornia | — | $205.04 |
| Stockton, CACalifornia | — | $197.85 |
| Vallejo, CACalifornia | — | $209.01 |
| Visalia, CACalifornia | — | $197.85 |
| Yuba City, CACalifornia | — | $197.85 |
| ColoradoColorado | — | $208.24 |
| ConnecticutConnecticut | — | $231.40 |
| DelawareDelaware | — | $210.11 |
| Fort Lauderdale, FLFlorida | — | $256.41 |
| Rest of FloridaFlorida | — | $238.60 |
| Atlanta, GAGeorgia | — | $226.28 |
| Rest of GeorgiaGeorgia | — | $220.20 |
| Hawaii, Guam, HIHawaii | — | $199.68 |
| IowaIowa | — | $181.08 |
| IdahoIdaho | — | $185.13 |
| East St. Louis, ILIllinois | — | $262.85 |
| Rest of IllinoisIllinois | — | $239.81 |
| Suburban Chicago, ILIllinois | — | $256.04 |
| IndianaIndiana | — | $186.08 |
| KansasKansas | — | $186.01 |
| KentuckyKentucky | — | $206.11 |
| New Orleans, LALouisiana | — | $219.46 |
| Rest of LouisianaLouisiana | — | $208.11 |
| Metropolitan Boston, MAMassachusetts | — | $222.80 |
| Rest of MassachusettsMassachusetts | — | $209.07 |
| Baltimore area, MDMaryland | — | $232.11 |
| Rest of MarylandMaryland | — | $212.70 |
| Rest of MaineMaine | — | $192.64 |
| Southern Maine, MEMaine | — | $196.11 |
| Detroit, MIMichigan | — | $248.22 |
| Rest of MichiganMichigan | — | $217.92 |
| MinnesotaMinnesota | — | $180.83 |
| Metropolitan Kansas City, MOMissouri | — | $211.35 |
| Metropolitan St. Louis, MOMissouri | — | $213.17 |
| Rest of MissouriMissouri | — | $207.94 |
| MississippiMississippi | — | $196.04 |
| MontanaMontana | — | $215.00 |
| North CarolinaNorth Carolina | — | $194.05 |
| North DakotaNorth Dakota | — | $185.14 |
| NebraskaNebraska | — | $180.46 |
| New HampshireNew Hampshire | — | $210.54 |
| Northern New JerseyNew Jersey | — | $233.02 |
| Rest of New JerseyNew Jersey | — | $228.79 |
| New MexicoNew Mexico | — | $221.72 |
| NevadaNevada | — | $206.72 |
| NYC suburbs and Long Island, NYNew York | — | $274.17 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $235.22 |
| Queens, NYNew York | — | $252.94 |
| Rest of New YorkNew York | — | $198.00 |
| OhioOhio | — | $211.81 |
| OklahomaOklahoma | — | $199.32 |
| Portland, OROregon | — | $208.85 |
| Rest of OregonOregon | — | $199.95 |
| Metropolitan Philadelphia, PAPennsylvania | — | $228.78 |
| Rest of PennsylvaniaPennsylvania | — | $208.85 |
| Rhode IslandRhode Island | — | $213.38 |
| South CarolinaSouth Carolina | — | $204.31 |
| South DakotaSouth Dakota | — | $181.61 |
| TennesseeTennessee | — | $187.89 |
| Austin, TXTexas | — | $212.06 |
| Beaumont, TXTexas | — | $207.70 |
| Brazoria, TXTexas | — | $204.60 |
| Dallas, TXTexas | — | $208.87 |
| Fort Worth, TXTexas | — | $209.10 |
| Galveston, TXTexas | — | $207.11 |
| Houston, TXTexas | — | $234.75 |
| Rest of TexasTexas | — | $208.05 |
| UtahUtah | — | $207.41 |
| VirginiaVirginia | — | $199.55 |
| Virgin Islands, VIUnited States Virgin Islands | — | $214.81 |
| VermontVermont | — | $189.76 |
| Rest of WashingtonWashington | — | $206.89 |
| King County, WAWashington | — | $221.61 |
| WisconsinWisconsin | — | $178.42 |
| West VirginiaWest Virginia | — | $231.28 |
| WyomingWyoming | — | $201.99 |
61781 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 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.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,884
- Code
- 61781
- Physician work
- 3.66
- Practice expense
- 1.27
- Malpractice
- 1.51
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.66 | × 1.000 | 3.6600 |
| Practice expense | 1.27 | × 1.011 | 1.2840 |
| Malpractice | 1.51 | × 0.985 | 1.4873 |
| Total RVUs | 6.4313 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$214.81
Facility: (3.66 × 1 + 1.27 × 1.011 + 1.51 × 0.985) × $33.4009 = $214.81
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. |
How 61781 has changed in Puerto Rico
61781 · 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 | $214.81 | RVU26D |
| 2026-07-01 | Not available in this setting | $214.81 | RVU26C |
| 2026-04-01 | Not available in this setting | $214.81 | RVU26B |
| 2026-01-01 | Not available in this setting | $214.81 | RVU26A |
| 2025-10-01 | Not available in this setting | $229.51 | RVU25D |
| 2025-07-01 | Not available in this setting | $229.51 | RVU25C |
| 2025-04-01 | Not available in this setting | $229.51 | RVU25B |
| 2025-01-01 | Not available in this setting | $229.51 | RVU25A |
| 2024-10-01 | Not available in this setting | $235.17 | RVU24D |
| 2024-07-01 | Not available in this setting | $235.17 | RVU24C |
| 2024-04-01 | Not available in this setting | $235.17 | RVU24B |
| 2024-03-09 | Not available in this setting | $235.17 | RVU24AR |
| 2024-01-01 | Not available in this setting | $231.33 | RVU24A |
| 2023-10-01 | Not available in this setting | $238.91 | RVU23D |
| 2023-07-01 | Not available in this setting | $239.24 | RVU23C |
| 2023-04-01 | Not available in this setting | $239.24 | RVU23B |
| 2023-01-01 | Not available in this setting | $239.24 | RVU23A |
| 2022-10-01 | Not available in this setting | $239.98 | RVU22D |
| 2022-07-01 | Not available in this setting | $239.98 | RVU22C |
| 2022-04-01 | Not available in this setting | $239.98 | RVU22B |
| 2022-01-01 | Not available in this setting | $239.98 | RVU22A |
| 2021-10-01 | Not available in this setting | $241.63 | RVU21D |
| 2021-07-01 | Not available in this setting | $241.63 | RVU21C |
| 2021-04-01 | Not available in this setting | $241.63 | RVU21B |
| 2021-01-01 | Not available in this setting | $241.63 | RVU21A |
| 2020-10-01 | Not available in this setting | $245.69 | RVU20D |
| 2020-07-01 | Not available in this setting | $245.69 | RVU20C |
| 2020-04-01 | Not available in this setting | $245.69 | RVU20B |
| 2020-01-01 | Not available in this setting | $245.69 | RVU20A |
| 2019-10-01 | Not available in this setting | $250.01 | RVU19D |
| 2019-07-01 | Not available in this setting | $250.01 | RVU19C |
| 2019-04-01 | Not available in this setting | $250.01 | RVU19B |
| 2019-01-01 | Not available in this setting | $250.01 | RVU19A |
| 2018-10-01 | Not available in this setting | $250.10 | RVU18D |
| 2018-07-01 | Not available in this setting | $250.10 | RVU18C |
| 2018-04-01 | Not available in this setting | $250.10 | RVU18B |
| 2018-01-01 | Not available in this setting | $250.10 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $221.91 | RVU17D |
| 2017-07-01 | Not available in this setting | $221.91 | RVU17C |
| 2017-04-01 | Not available in this setting | $221.91 | RVU17B |
| 2017-01-01 | Not available in this setting | $221.91 | RVU17A |
| 2016-10-01 | Not available in this setting | $193.61 | RVU16D |
| 2016-07-01 | Not available in this setting | $193.61 | RVU16C |
| 2016-04-01 | Not available in this setting | $193.61 | RVU16B |
| 2016-01-01 | Not available in this setting | $193.61 | RVU16A |
| 2015-10-01 | Not available in this setting | $194.98 | RVU15D |
| 2015-07-01 | Not available in this setting | $194.98 | RVU15C |
| 2015-04-01 | Not available in this setting | $194.01 | RVU15B |
| 2015-01-01 | Not available in this setting | $194.01 | RVU15A |
| 2014-10-01 | Not available in this setting | $189.61 | RVU14D |
| 2014-07-01 | Not available in this setting | $189.61 | RVU14C |
| 2014-04-01 | Not available in this setting | $189.61 | RVU14B |
| 2014-01-01 | Not available in this setting | $189.61 | RVU14A |
| 2013-10-01 | Not available in this setting | $182.00 | RVU13D |
| 2013-07-01 | Not available in this setting | $182.00 | RVU13C |
| 2013-04-01 | Not available in this setting | $182.00 | RVU13B |
| 2013-01-01 | Not available in this setting | $182.00 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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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