No office rate
Both are for supratentorial AVM surgery; 61684 represents the simple classification, while 61686 represents the complex classification.
On this page
CMS RVU26D · Effective 2026-10-01
61686 Brain AVM surgery Medicare reimbursement rates in Ohio
Reports open intracranial surgery for a complex arteriovenous malformation located above the tentorium, typically performed by a neurosurgeon. Compare 61686 office and facility rates across CMS payment localities in Ohio.
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 61686 in Ohio?
Ohio 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
$4158.35
1 of 1 localities have a supported rate.
Payment area: Ohio
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 61686: Complex supratentorial brain AVM surgery
Reports open intracranial surgery for a complex arteriovenous malformation located above the tentorium, typically performed by a neurosurgeon.
This code describes open surgery to treat a complex arteriovenous malformation (AVM) in the supratentorial part of the brain, such as the cerebral hemispheres. A neurosurgeon typically performs the operation through an intracranial approach, often in a hospital operating room. The surgeon works to remove or otherwise surgically treat the abnormal vessel connection; this is distinct from catheter-based embolization.
Choose this code when the operative documentation supports both the supratentorial location and the complex classification. The record should describe the AVM, its location, the operative approach, and the work performed. CMS assigns 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 the others are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation. Team surgery is not permitted, and modifier 50 is inappropriate for this code.
CMS billing rules for 61686
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU65.81 · 52%
- Practice expense (office) RVU33.61 · 26%
- Malpractice RVU27.78 · 22%
65
Medicare services in 2024 · #5188 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.
61686 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Both represent complex AVM surgery, but 61692 is for an infratentorial lesion; 61686 is for a supratentorial lesion.
No office rate
61624 describes catheter-based permanent occlusion or embolization in the central nervous system. This code describes open intracranial surgery for a complex supratentorial AVM.
Compare 61686 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
Ohio →
Office / nonfacility
Unavailable
Facility
$4158.35
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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 61686 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
6,861
- Code
- 61686
- Physician work
- 65.81
- Practice expense
- 33.61
- Malpractice
- 27.78
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 65.81 | × 1.000 | 65.8100 |
| Practice expense | 33.61 | × 0.913 | 30.6859 |
| Malpractice | 27.78 | × 1.008 | 28.0022 |
| Total RVUs | 124.4982 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$4158.35
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 65.81 | 1 |
| Practice expense | 33.61 | 0.913 |
| Malpractice | 27.78 | 1.008 |
(65.81 × 1 + 33.61 × 0.913 + 27.78 × 1.008) × $33.4009 = $4158.35
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.
61686 billing questions
How is this code different from 61684?
Both describe surgery for a supratentorial intracranial AVM. Use 61686 for the complex classification and 61684 for the simple classification, as supported by the operative documentation.
When would 61690 or 61692 be more appropriate?
Those codes describe surgery for an infratentorial AVM. This code is for a complex AVM located supratentorially.
Is catheter-based AVM embolization reported with this code?
No. This code describes open intracranial surgery; code 61624 describes catheter-based permanent occlusion or embolization in the central nervous system.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted under the CMS facts for this code.
Should modifier 50 be used for AVMs on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
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.
6,85861680,,Intracranial vessel surgery,A,,31.74,20.93,NA,20.93,,13.42,66.09,66.09,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,85961682,,Intracranial vessel surgery,A,,61.82,28.89,NA,28.89,,25.54,116.25,116.25,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86061684,,Intracranial vessel surgery,A,,40.60,24.04,NA,24.04,,17.13,81.77,81.77,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86161686,,Intracranial vessel surgery,A,,65.81,33.61,NA,33.61,,27.78,127.20,127.20,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86261690,,Intracranial vessel surgery,A,,30.56,20.12,NA,20.12,,12.90,63.58,63.58,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86361692,,Intracranial vessel surgery,A,,53.23,28.09,NA,28.09,,22.47,103.79,103.79,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,86461697,,Brain aneurysm repr complx,A,,61.82,32.05,NA,32.05,,26.02,119.89,119.89,0,090,0.11,0.76,0.13,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703