No office rate
61105 describes twist-drill access for subdural or ventricular puncture. Use 61120 when the operative approach is a burr hole.
On this page
CMS RVU26D · Effective 2026-10-01
61120 Ventricular puncture Medicare reimbursement rates in Nevada
Reports neurosurgical access to a cerebral ventricle through a burr hole for diagnostic sampling or delivery of medication or another substance. Compare 61120 office and facility rates across CMS payment localities in Nevada.
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 61120 in Nevada?
Nevada 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
$751.97
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
Neurosurgery
About 61120: Burr-hole ventricular puncture
Reports neurosurgical access to a cerebral ventricle through a burr hole for diagnostic sampling or delivery of medication or another substance.
A neurosurgeon creates a burr hole to reach a cerebral ventricle with a puncture instrument. The access can be used to obtain ventricular cerebrospinal fluid or to introduce medication or another substance for diagnosis or treatment. This is a surgical service typically performed in a facility, such as during evaluation or treatment of a patient with a need for direct ventricular access.
Report 61120 when the operative service is ventricular puncture through a burr hole, rather than placement of a ventricular catheter or a procedure directed at a brain lesion. The operative report should identify the ventricular access, the reason for puncture, and any sampling or injection performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 61120
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.36 · 40%
- Practice expense (office) RVU9.87 · 43%
- Malpractice RVU3.93 · 17%
24
Medicare services in 2024 · #5823 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.
61120 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
61107 is for ventricular catheter placement through a twist-drill opening. 61120 is for ventricular puncture through a burr hole.
No office rate
61210 covers burr-hole placement of a ventricular catheter, reservoir, or drainage connection; 61120 covers puncture access without that catheter-placement service.
$163.50
62270 is a lumbar puncture for spinal access. Choose 61120 when the surgeon accesses a cerebral ventricle through a burr hole.
Compare 61120 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$751.97
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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 61120 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
6,747
- Code
- 61120
- Physician work
- 9.36
- Practice expense
- 9.87
- Malpractice
- 3.93
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.36 | × 1.000 | 9.3600 |
| Practice expense | 9.87 | × 1.001 | 9.8799 |
| Malpractice | 3.93 | × 0.833 | 3.2737 |
| Total RVUs | 22.5136 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$751.97
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.36 | 1 |
| Practice expense | 9.87 | 1.001 |
| Malpractice | 3.93 | 0.833 |
(9.36 × 1 + 9.87 × 1.001 + 3.93 × 0.833) × $33.4009 = $751.97
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.
61120 billing questions
How is 61120 different from 61107?
61120 describes ventricular puncture through a burr hole. 61107 uses a twist-drill opening for ventricular catheter placement, so select based on the access and service actually performed.
When is 61210 a better fit?
Use 61210 for burr-hole placement of a ventricular catheter, reservoir, or drainage-system connection. 61120 describes puncture access rather than that catheter or device placement.
Can 61120 be reported with a brain biopsy code?
The operative service must support each reported procedure. A burr-hole approach alone does not establish a separate biopsy service; the documentation must show that a brain or lesion biopsy was performed.
Should modifier 50 be appended for bilateral ventricular access?
No. CMS identifies modifier 50 as inappropriate for this code’s descriptor or anatomy.
What supports assistant-at-surgery payment?
The record must document why an assistant was medically necessary for the operation. CMS permits assistant payment for 61120 only with that medical-necessity documentation.
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.
6,74461107,,Tdh pnxr implt ventr cath,A,,4.87,1.70,NA,1.70,,2.04,8.61,8.61,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74561108,,Tdh pnxr evac&/drg sdrl hmta,A,,11.35,11.88,NA,11.88,,4.58,27.81,27.81,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,7466110F,,Counsel prov driving risks,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74761120,,Burr hole for ventr puncture,A,,9.36,9.87,NA,9.87,,3.93,23.16,23.16,0,090,0.11,0.76,0.13,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74861140,,Burr hole/treph bx brain/les,A,,16.80,14.14,NA,14.14,,7.02,37.96,37.96,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,74961150,,Bur hol/trph drg brn abs/cst,A,,18.43,13.82,NA,13.82,,7.76,40.01,40.01,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,75061151,,Burr hole/treph sbsq tapping,A,,13.15,11.20,NA,11.20,,5.54,29.89,29.89,0,090,0.11,0.76,0.13,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097