Billing code 61026: Ventricular injectionMedicare rate & RVUs in Delaware
Reports delivery of medication or another substance into the cerebral ventricles through an established ventricular catheter, rather than by cisternal access.
CMS doesn’t publish an office rate for 61026 in Delaware.
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 9 sections
What 61026 covers
This service involves delivering medication or another substance into the cerebral ventricles through a ventricular catheter that was implanted previously. A neurosurgeon or another qualified physician managing ventricular access may perform it in a hospital or other procedural setting. Intraventricular treatment is a typical clinical use; the code describes the injection procedure, not a particular medication or diagnosis.
Report the code when documentation identifies the ventricular route, the established catheter, and the substance administered. It is distinct from a new ventricular puncture for drainage and from injection through cisternal access. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple 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 for this anatomy. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.
61026 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $103.13 |
How the 61026 rate is calculated
Each of 61026’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 · 61026
RVUs × geographic indexes × conversion factor
Work1.65
1.65 RVUs× 1.000 GPCI
Practice expense1.01
1.01 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
3.1400
Conversion factor
$33.4009
Medicare rate
$104.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61026
The CMS indicators that decide how 61026 is paid alongside other services.
CMS payment indicators · 61026
Ventricular injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
61026 without 51 · national facility
$104.88
Ventricular injection
61026-51 · Second procedure: 50%
$52.44
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
61026 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61055Cisternal injection
- Choose 61026 for injection through an established ventricular catheter. Choose 61055 when the substance is injected through cisternal access.
- 61070Shunt access
- 61070 describes puncturing shunt tubing or a reservoir for aspiration or injection. 61026 identifies injection into the ventricles through an established ventricular catheter.
- 61020Ventricular drainage
- 61020 is for ventricular puncture for drainage. 61026 is for injection through an established ventricular catheter.
61026 billing questions
How is this different from 61055?
61026 uses an established ventricular catheter to deliver the substance into the cerebral ventricles. 61055 is for injection using cisternal access.
Can the medication be reported separately?
The procedure code identifies the ventricular injection, not the medication. Report a drug separately only when its own coding and coverage requirements support separate reporting.
Should modifier 50 be appended for bilateral treatment?
No. The anatomy makes modifier 50 inappropriate for this service.
What documentation supports reporting 61026?
Document that an established ventricular catheter was used, the substance delivered, and the clinical purpose of the injection.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
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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