CPT code 61889: Neurostimulator implant, skull-mounted generator or receiver2026 Medicare rate & RVUs in Guam
Reports implantation of a skull-mounted cranial neurostimulator pulse generator or receiver, such as the cranial device used for responsive neurostimulation in epilepsy.
CMS doesn’t publish an office rate for 61889 in Guam.
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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On this page 9 sections
What 61889 covers
A neurosurgeon implants a pulse generator or receiver designed to mount to the skull and connects it to intracranial neuroelectrodes. A common clinical setting is surgery for responsive neurostimulation in drug-resistant focal epilepsy, where the cranial device can monitor brain activity and deliver stimulation through connected electrodes. The service is performed in an operating room, often as part of a larger neurostimulation implantation procedure.
Report this code for the skull-mounted generator or receiver insertion, not simply for placing the intracranial electrodes. The operative report should establish the skull-mounted device, its insertion, and the electrode connections; report electrode implantation separately when performed and supported by the applicable code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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.
61889 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $1,677.34 |
How the 61889 rate is calculated
Each of 61889’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 · 61889
RVUs × geographic indexes × conversion factor
Work25.11
25.11 RVUs× 1.000 GPCI
Practice expense16.68
16.68 RVUs× 1.000 GPCI
Malpractice10.61
10.61 RVUs× 1.000 GPCI
Adjusted RVUs
52.4000
Conversion factor
$33.4009
Medicare rate
$1,750.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61889
61889 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61889
Neurostimulator implant, skull-mounted generator or receiver
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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. |
| Split (54/55/56) | 0.11/0.76/0.13 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 61889
Neurostimulator implant, skull-mounted generator or receiver
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 50 · payment effect
With and without the modifier
61889 without 50 · national facility
$1,750.21
Neurostimulator implant, skull-mounted generator or receiver
61889-50 · Bilateral: 150%
$2,625.32
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
61889 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 61885Neurostimulator generatorOne electrode array
- Use 61889 for insertion of a skull-mounted cranial generator or receiver. Code 61885 describes a different cranial generator or receiver insertion associated with a single electrode array.
- 61886Neurostimulator generatorTwo or more arrays
- Code 61886 describes a cranial generator or receiver insertion associated with multiple electrode arrays. The defining distinction for 61889 is the skull-mounted device.
- 61891Neurostimulator revisionSkull-mounted generator or receiver
- Code 61891 is for revision or replacement of a skull-mounted cranial neurostimulator. Code 61889 reports insertion, not revision or replacement.
- 61892Neurostimulator removalSkull-mounted generator or receiver
- Code 61892 reports removal of a skull-mounted cranial neurostimulator pulse generator or receiver; 61889 reports its insertion.
61889 billing questions
How is this different from codes 61885 and 61886?
This code identifies insertion of a generator or receiver designed to mount to the skull. Codes 61885 and 61886 describe other cranial neurostimulator generator or receiver insertions, distinguished by the number of connected electrode arrays.
Does this code include placement of the intracranial electrodes?
Do not treat the generator insertion as a substitute for separately performed electrode implantation. Report the electrode placement under its applicable code when performed and documented.
Can it be reported with an electrode implantation code?
Yes, when the skull-mounted generator or receiver and intracranial electrodes are both implanted during the session, report each service under its applicable code and document the work performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How should bilateral work be reported?
When the service is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted 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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