CPT code 61891: Neurostimulator revision, skull-mounted generator or receiver2026 Medicare rate & RVUs

Medicare pays $837.36 for 61891 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 61891 covers

A neurosurgeon or functional neurosurgeon uses this service to revise or replace an implanted cranial neurostimulator pulse generator or receiver mounted at the skull. The work may involve reopening the prior operative site, addressing the existing device or its connections, and implanting a replacement unit when needed. A cranially mounted responsive neurostimulation system used for drug-resistant epilepsy is a typical clinical context. The procedure is generally performed in an operating room rather than an office.

Choose this code for revision or replacement of the skull-mounted generator or receiver, not simply because the patient already has cranial electrodes. The operative report should identify the device, the reason for revision or replacement, the work performed, and the resulting configuration. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, 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.

Where 61891 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

61891 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 61891 rate is calculated

Each of 61891’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.

Payment rules and modifiers for 61891

61891 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

61891 compared with similar codes

How to choose

61889Neurostimulator implantSkull-mounted generator or receiver

Use 61891 for revision or replacement of an existing skull-mounted cranial generator or receiver. Code 61889 applies to its specified insertion or replacement circumstances.

61892Neurostimulator removalSkull-mounted generator or receiver

Code 61892 describes removal of the skull-mounted pulse generator or receiver; 61891 is for revision or replacement rather than removal alone.

61885Neurostimulator generatorOne electrode array

Code 61885 concerns a neurostimulator generator in a different device configuration, rather than the skull-mounted cranial generator or receiver addressed by 61891.

61880Neuroelectrode surgeryIntracranial lead revision or removal

Code 61880 concerns revision or removal of a neuroelectrode. Code 61891 concerns the skull-mounted pulse generator or receiver, not the electrode itself.

Codes related to 61891

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates