Billing code 61698: Aneurysm repairMedicare rate & RVUs in Guam
Open surgical repair of a complex aneurysm in the brain’s posterior circulation, such as the vertebrobasilar system, reported for the operative repair.
CMS doesn’t publish an office rate for 61698 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.
On this page 9 sections
What 61698 covers
A neurosurgeon reports this code for operative repair of a complex intracranial aneurysm in the posterior circulation, including the vertebral and basilar arterial system. A basilar artery aneurysm is a representative site. The service is performed in an operating room, generally in a hospital, as part of an intracranial surgical procedure; it is distinct from catheter-based aneurysm treatment.
The operative report should support the aneurysm’s location in the posterior circulation, the complex nature of the repair, and the work performed. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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.
61698 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $4,125.97 |
How the 61698 rate is calculated
Each of 61698’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 · 61698
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 67.89Practice expense 34.34Malpractice 28.66
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61698
61698 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61698
Aneurysm repair
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 61698
Aneurysm repair
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 51 · payment effect
With and without the modifier
61698 without 51 · national facility
$4,371.84
Aneurysm repair
61698-51 · Second procedure: 50%
$2,185.92
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%).
61698 compared with similar codes
Compare codes
61698 vs 61697 vs 61624: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61697Aneurysm repair
- Both codes describe complex intracranial aneurysm repair; select 61698 for posterior-circulation anatomy and 61697 for anterior-circulation anatomy.
- 61624CNS embolization
- 61698 is open surgical repair. Use 61624 for a catheter-based permanent occlusion or embolization service when that is the treatment performed.
61698 billing questions
How does 61698 differ from 61697?
61698 is for a complex aneurysm in the posterior circulation; 61697 is its anterior-circulation counterpart. The operative documentation should establish the aneurysm’s vascular location.
Can 61698 be used for endovascular aneurysm treatment?
No. It describes open operative repair. Catheter-based permanent occlusion or embolization of a central nervous system vessel may instead be reported with 61624 when that service is performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. The operative surgeon’s related routine follow-up during that period is included.
Can modifier 50 be appended for aneurysms on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
When may an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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