No office rate
Both codes cover cranial halo application, but 20661 is for a four-pin configuration and 20664 is for six or more pins.
On this page
CMS RVU26D · Effective 2026-10-01
20661 Cranial halo Medicare reimbursement rates in Colorado
Reports application of a four-pin cranial halo to stabilize the cervical spine, such as for selected fractures or instability requiring rigid immobilization. Compare 20661 office and facility rates across CMS payment localities in Colorado.
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 20661 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$563.33
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Orthopedic procedure
About 20661: Four-pin cranial halo application
Reports application of a four-pin cranial halo to stabilize the cervical spine, such as for selected fractures or instability requiring rigid immobilization.
An orthopedic or neurosurgical provider applies a rigid ring secured to the skull with four pins to support cervical spine immobilization. The halo may be connected to a vest or another support as part of treatment for conditions such as a cervical fracture or instability. This service is generally performed in a hospital or other procedural setting when rigid external stabilization is needed.
Select this code for the four-pin cranial halo application; the six-or-more-pin application is reported with 20664. The application code includes removal of the halo. The record should support the clinical need for rigid stabilization and the pin configuration used. CMS assigns a 90-day global period, including 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 20661
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.13 · 31%
- Practice expense (office) RVU9.68 · 58%
- Malpractice RVU1.76 · 11%
92
Medicare services in 2024 · #4937 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.
20661 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
Use 20661 for a cranial halo; 20660 describes application of cranial tongs, calipers, or another traction device.
$122.10
Code 20661 covers halo application, including removal. Code 20665 describes removal of tongs or a halo previously applied by another physician.
Compare 20661 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$563.33
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 20661 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
1,777
- Code
- 20661
- Physician work
- 5.13
- Practice expense
- 9.68
- Malpractice
- 1.76
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.13 | × 1.012 | 5.1916 |
| Practice expense | 9.68 | × 1.064 | 10.2995 |
| Malpractice | 1.76 | × 0.781 | 1.3746 |
| Total RVUs | 16.8656 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$563.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.13 | 1.012 |
| Practice expense | 9.68 | 1.064 |
| Malpractice | 1.76 | 0.781 |
(5.13 × 1.012 + 9.68 × 1.064 + 1.76 × 0.781) × $33.4009 = $563.33
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
20661 billing questions
When should 20661 be selected instead of 20664?
Use 20661 for application of a four-pin cranial halo. Code 20664 describes the six-or-more-pin cranial halo application.
Is halo removal separately reported after 20661?
Removal is included in the application service reported with 20661. Code 20665 is for removal of tongs or a halo previously applied by another physician.
Can modifier 50 be used for a halo applied on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; the cranial halo application is not reported as a bilateral service.
What documentation supports reporting 20661?
Document the clinical reason for rigid cranial stabilization, the application performed, and the four-pin configuration. The record should distinguish this service from a halo using six or more pins.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Other procedures performed in the same session are subject to the standard multiple-procedure payment reduction.
Can an assistant or co-surgeon be billed for this procedure?
Assistant-at-surgery payment is restricted for 20661. CMS does not permit co-surgeon or team-surgery billing 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.
1,77420615,,Treatment of bone cyst,A,,2.27,4.95,,1.80,,0.25,7.47,4.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77520650,,Insert and remove bone pin,A,,2.22,4.87,,2.19,,0.38,7.47,4.79,0,010,0.10,0.80,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77620660,,Apply rem fixation device,A,,3.90,1.27,NA,1.27,,1.26,6.43,6.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77720661,,Application halo cranial,A,,5.13,9.68,NA,9.68,,1.76,16.57,16.57,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77820662,,Application halo pelvic,A,,6.22,7.46,NA,7.46,,1.32,15.00,15.00,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,77920663,,Application halo femoral,A,,5.60,7.11,NA,7.11,,1.21,13.92,13.92,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78020664,,Appl halo cranial 6+pins,A,,9.81,14.26,NA,14.26,,4.13,28.20,28.20,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899