No office rate
Choose based on the documented target: this code addresses the intracranial trigeminal nerve, while 61791 addresses the trigeminal tract.
On this page
CMS RVU26D · Effective 2026-10-01
61790 Trigeminal nerve treatment Medicare reimbursement rates in Pennsylvania
Reports stereotactic lesioning of the intracranial trigeminal nerve, typically to treat trigeminal neuralgia when this targeted procedure is performed. Compare 61790 office and facility rates across CMS payment localities in Pennsylvania.
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 61790 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$859.39–$949.70
2 of 2 localities have a supported rate.
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 61790: Stereotactic trigeminal nerve lesioning
Reports stereotactic lesioning of the intracranial trigeminal nerve, typically to treat trigeminal neuralgia when this targeted procedure is performed.
This service uses stereotactic localization to create a lesion in the intracranial trigeminal nerve, interrupting pain signals. It is most often performed for severe trigeminal neuralgia that has not responded adequately to other treatment. A neurosurgeon typically performs the procedure in a hospital setting; the specific lesioning method should be supported by the operative record. The key distinction is that the target is the trigeminal nerve itself, rather than the trigeminal tract or a separate cranial lesion.
Report the code when the documented procedure matches that target and stereotactic approach. The operative note should identify the indication, target, method, and side treated. Medicare 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 61790
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU11.31 · 42%
- Practice expense (office) RVU10.89 · 41%
- Malpractice RVU4.68 · 17%
386
Medicare services in 2024 · #3767 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.
61790 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$497.36–$554.56
This code is for stereotactic lesioning of the intracranial nerve; 64600 concerns neurolytic treatment of specified peripheral trigeminal branches.
$1,027.81–$1,153.63
Use this code for intracranial stereotactic nerve lesioning. Code 64605 describes neurolytic treatment of trigeminal divisions at the foramen ovale.
Compare 61790 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$949.70
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$859.39
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61790 billing questions
How does this differ from 61791?
This code targets the intracranial trigeminal nerve. Code 61791 is for a procedure directed at the trigeminal tract, so the documented treatment target distinguishes them.
Can this be reported for trigeminal neuralgia treated at a peripheral branch?
No. This code describes stereotactic treatment of the intracranial nerve; a procedure directed at peripheral trigeminal branches may fit a different code, such as 64600 or 64605.
What documentation supports reporting this code?
The operative record should establish the trigeminal neuralgia indication, stereotactic method, intracranial nerve target, lesioning performed, and side treated.
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.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be billed for this service?
Assistant-at-surgery services are not paid 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.
6,88461781,,Scan proc cranial intra,A,,3.66,1.27,NA,1.27,,1.51,6.44,6.44,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88561782,,Scan proc cranial extra,A,,3.10,0.76,NA,0.76,,0.46,4.32,4.32,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88661783,,Scan proc spinal,A,,3.66,1.24,NA,1.24,,1.31,6.21,6.21,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88761790,,Treat trigeminal nerve,A,,11.31,10.89,NA,10.89,,4.68,26.88,26.88,0,090,0.11,0.76,0.13,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88861791,,Treat trigeminal tract,A,,15.02,12.38,NA,12.38,,6.33,33.73,33.73,0,090,0.11,0.76,0.13,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88961796,,Srs cranial lesion simple,A,,13.58,11.06,NA,11.06,,5.68,30.32,30.32,0,090,0.11,0.76,0.13,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,89061797,,Srs cran les simple addl,A,,3.39,1.18,NA,1.18,,1.42,5.99,5.99,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00