No office rate
Use 61684 for a simple dural intracranial AVM operation. Use 61686 when the dural lesion and operative work meet the complex level.
On this page
CMS RVU26D · Effective 2026-10-01
61684 Dural AVM surgery Medicare reimbursement rates in California
Reports operative treatment of a simple intracranial dural arteriovenous malformation, such as surgical disconnection of its abnormal vascular connection. Compare 61684 office and facility rates across CMS payment localities in California.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 61684 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$2565.85–$2969.79
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $403.94 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 61684 pays more and less in California
Neurosurgery
About 61684: Simple dural intracranial AVM surgery
Reports operative treatment of a simple intracranial dural arteriovenous malformation, such as surgical disconnection of its abnormal vascular connection.
This code describes open surgical treatment of a simple arteriovenous malformation involving intracranial dura. A neurosurgeon typically performs the operation in a hospital operating room, working to disconnect or otherwise surgically treat the abnormal dural vascular connection. The operative report should establish that the lesion is dural and intracranial and explain the surgical work and why the case meets the simple level rather than a more complex category.
Select this code for the documented lesion and operative complexity; do not substitute a code for a different anatomic subtype or for endovascular treatment. The 90-day global includes 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 additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. CMS does not permit team-surgery payment for this code.
CMS billing rules for 61684
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU40.60 · 50%
- Practice expense (office) RVU24.04 · 29%
- Malpractice RVU17.13 · 21%
28
Medicare services in 2024 · #5715 by national volume
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.
61684 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
This code is specific to a dural AVM. Code 61690 describes surgery for a different intracranial AVM anatomic subtype.
No office rate
61624 describes permanent transcatheter occlusion or embolization of a CNS vessel; 61684 is for surgical treatment of a dural AVM.
Compare 61684 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $2610.33 |
| Chico | Office Unavailable | Facility $2565.85 |
| El Centro | Office Unavailable | Facility $2568.71 |
| Fresno | Office Unavailable | Facility $2565.85 |
| Hanford-Corcoran | Office Unavailable | Facility $2565.85 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $2741.49 |
| Madera | Office Unavailable | Facility $2565.85 |
| Merced | Office Unavailable | Facility $2565.85 |
| Modesto | Office Unavailable | Facility $2565.85 |
| Napa | Office Unavailable | Facility $2790.46 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $2699.60 |
| Redding | Office Unavailable | Facility $2565.85 |
| Rest Of California | Office Unavailable | Facility $2565.85 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $2748.58 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $2645.41 |
| Salinas | Office Unavailable | Facility $2635.42 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $2667.21 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $2879.69 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $2860.24 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $2969.79 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $2890.26 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $2600.37 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $2666.82 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $2636.97 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $2689.47 |
| Stockton | Office Unavailable | Facility $2565.85 |
| Vallejo | Office Unavailable | Facility $2762.43 |
| Visalia | Office Unavailable | Facility $2565.85 |
| Yuba City | Office Unavailable | Facility $2565.85 |
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61684 billing questions
How do I distinguish this code from 61686?
Both concern surgical treatment of a dural intracranial AVM. This code is for the simple level; 61686 is for the complex level, supported by the operative details and applicable CPT criteria.
Can I report this for endovascular embolization?
No. This code describes surgical treatment. Code 61624 is used for permanent transcatheter occlusion or embolization of a central nervous system vessel when that endovascular service is performed.
Are related postoperative visits separately included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures paid when performed in the same session?
CMS pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the others.
Can I use modifier 50 or report co-surgeons?
Modifier 50 is inappropriate for this descriptor and anatomy. Co-surgeons are paid only when supporting documentation is provided.
Can an assistant surgeon be paid for this operation?
Assistant-at-surgery payment may be available. CMS does not permit team-surgery payment 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,85761651,,Evasc prlng admn rx agnt add,A,,4.14,1.19,NA,1.19,,1.37,6.70,6.70,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,85861680,,Intracranial vessel surgery,A,,31.74,20.93,NA,20.93,,13.42,66.09,66.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,85961682,,Intracranial vessel surgery,A,,61.82,28.89,NA,28.89,,25.54,116.25,116.25,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86061684,,Intracranial vessel surgery,A,,40.60,24.04,NA,24.04,,17.13,81.77,81.77,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86161686,,Intracranial vessel surgery,A,,65.81,33.61,NA,33.61,,27.78,127.20,127.20,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86261690,,Intracranial vessel surgery,A,,30.56,20.12,NA,20.12,,12.90,63.58,63.58,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86361692,,Intracranial vessel surgery,A,,53.23,28.09,NA,28.09,,22.47,103.79,103.79,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00