Billing code 61791: Trigeminal tract lesionMedicare rate & RVUs in Ohio
Reports stereotactic creation of a lesion in the trigeminal tract to interrupt facial pain transmission, typically for selected patients with severe, persistent facial pain.
CMS doesn’t publish an office rate for 61791 in Ohio.
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 61791 covers
This code represents a stereotactic procedure that creates a lesion in the trigeminal tract to interrupt pain signals. It is distinct from lesioning the trigeminal nerve itself. Neurosurgeons typically perform the procedure in a hospital operating room for carefully selected patients with severe facial pain, such as pain that has not responded adequately to other treatment. The operative report should identify the tract target and describe the lesioning approach.
Report the code for the tract-targeting procedure, not for a procedure directed at the trigeminal nerve or for radiation treatment. Documentation should support the target, stereotactic method, indication, and work performed. CMS assigns a 90-day global period, which 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 other procedures are subject to the standard multiple-procedure reduction. 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.
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.
61791 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,092.33 |
How the 61791 rate is calculated
Each of 61791’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 · 61791
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.02Practice expense 12.38Malpractice 6.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61791
61791 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 61791
Trigeminal tract lesion
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 61791
Trigeminal tract lesion
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 50 · payment effect
With and without the modifier
61791 without 50 · national facility
$1,126.61
Trigeminal tract lesion
61791-50 · Bilateral: 150%
$1,689.91
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
61791 compared with similar codes
Compare codes
61791 vs 61790 vs 61715 vs 61796: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 61790Trigeminal nerve treatment
- Choose 61791 when the operative target is the trigeminal tract; choose 61790 when the lesion is created in the trigeminal nerve.
- 61715Mrgfus strtctc ablt trgt icr
- 61715 describes stereotactic radiosurgery for a cranial nerve, with or without a brainstem lesion. 61791 involves surgically creating a lesion in the trigeminal tract.
- 61796Cranial radiosurgery
- 61796 is for stereotactic radiosurgery of a simple cranial lesion. It is not the tract-lesioning code for a procedure that creates a lesion in the trigeminal tract.
61791 billing questions
How does this differ from 61790?
61791 is for lesioning the trigeminal tract. 61790 is for lesioning the trigeminal nerve; the operative target determines the code.
Can this be reported for stereotactic radiosurgery?
No. This code describes creation of a lesion in the trigeminal tract, not radiation treatment. For stereotactic radiosurgery directed at a cranial nerve, consider 61715 when its requirements are met.
What documentation supports reporting 61791?
The operative report should identify the trigeminal tract as the target, describe the stereotactic lesioning performed, and support the facial-pain indication.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be used for a bilateral procedure?
CMS identifies this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
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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