No office rate
20660 describes cranial tongs, a caliper, or another halo-type device. Use 20664 for a cranial halo secured with six or more pins.
On this page
CMS RVU26D · Effective 2026-10-01
20664 Cranial halo Medicare reimbursement rates in Kansas
Reports application and removal of a cranial halo using six or more pins to immobilize the head and cervical spine, such as for fracture stabilization. Compare 20664 office and facility rates across CMS payment localities in Kansas.
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 20664 in Kansas?
Kansas 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
$827.76
1 of 1 localities have a supported rate.
Payment area: Kansas
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 20664: Cranial halo application with six or more pins
Reports application and removal of a cranial halo using six or more pins to immobilize the head and cervical spine, such as for fracture stabilization.
This service covers applying a cranial halo secured with six or more pins and its removal. Orthopedic spine surgeons and neurosurgeons may use the device to immobilize the head and cervical spine, including during treatment of a cervical fracture or instability. The service may be performed in a hospital or another setting equipped for the procedure.
Select the code when the documented device is a cranial halo and the pin count meets the six-or-more threshold; cranial tongs and halos with different configurations have distinct coding. The operative record should identify the device, pin count, indication, and work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 20664
- 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 RVU9.81 · 35%
- Practice expense (office) RVU14.26 · 51%
- Malpractice RVU4.13 · 15%
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.
20664 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Both codes concern cranial halo application. 20664 is distinguished by the six-or-more-pin threshold.
$109.38
20665 describes separate removal of cranial tongs or a halo. Removal included in the 20664 service is not separately reported with it.
No office rate
20690 describes application of a uniplanar external fixation system, not cranial halo immobilization.
Compare 20664 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
Kansas →
Office / nonfacility
Unavailable
Facility
$827.76
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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 20664 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
1,780
- Code
- 20664
- Physician work
- 9.81
- Practice expense
- 14.26
- Malpractice
- 4.13
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.81 | × 1.000 | 9.8100 |
| Practice expense | 14.26 | × 0.904 | 12.8910 |
| Malpractice | 4.13 | × 0.504 | 2.0815 |
| Total RVUs | 24.7826 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$827.76
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.81 | 1 |
| Practice expense | 14.26 | 0.904 |
| Malpractice | 4.13 | 0.504 |
(9.81 × 1 + 14.26 × 0.904 + 4.13 × 0.504) × $33.4009 = $827.76
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.
20664 billing questions
How is this code distinguished from 20660?
Use 20664 for a cranial halo with six or more pins. Code 20660 describes application of cranial tongs, a caliper, or another halo-type device.
Is halo removal reported separately?
Removal is included in the cranial halo service. Do not separately report 20665 for removal that is part of the same service.
Does modifier 50 apply if both sides of the skull are involved?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 is not used.
What documentation supports choosing this code?
The operative documentation should identify a cranial halo, establish that six or more pins were used, and describe the indication and procedure.
How does the multiple-procedure payment rule affect this service?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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 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.
1,77720661,,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
1,78120665,,Rmvl tongs/halo anthr indiv,A,,1.33,2.09,,1.13,,0.11,3.53,2.57,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78220670,,Removal implant superficial,A,,1.75,9.07,,2.17,,0.27,11.09,4.19,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,78320680,,Removal of implant deep,A,,5.81,12.05,,4.94,,1.06,18.92,11.81,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958