61891 Neurostimulator revision Medicare reimbursement rates in Indiana

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.