No office rate
Use 61796 for a simple cranial lesion; use 61798 when the lesion is classified as complex. The lesion classification, not laterality, distinguishes these codes.
On this page
CMS RVU26D · Effective 2026-10-01
61798 Cranial radiosurgery Medicare reimbursement rates in Rhode Island
Reports single-session stereotactic radiosurgery for a complex cranial lesion, such as an intracranial tumor treated with focused radiation rather than open resection. Compare 61798 office and facility rates across CMS payment localities in Rhode Island.
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 61798 in Rhode Island?
Rhode Island 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
$1336.00
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Stereotactic radiosurgery
About 61798: Complex cranial stereotactic radiosurgery
Reports single-session stereotactic radiosurgery for a complex cranial lesion, such as an intracranial tumor treated with focused radiation rather than open resection.
This code represents single-session stereotactic radiosurgery directed at a complex intracranial lesion. Neurosurgeons and radiation oncologists commonly participate in treating brain metastases, meningiomas, and vestibular schwannomas with focused radiation using stereotactic localization and treatment planning. The service is typically delivered in a hospital or radiation-treatment setting without open removal of the lesion.
Report 61798 for the first complex lesion in the session; report 61799 for each additional complex lesion. Choose the complex rather than simple sequence based on the documented lesion classification, not lesion count or laterality alone. Records should identify the treated target or targets, support their complex classification, and document stereotactic planning and treatment. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate, including when targets are on both sides of the brain.
CMS billing rules for 61798
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.35 · 48%
- Practice expense (office) RVU12.76 · 32%
- Malpractice RVU7.96 · 20%
3K
Medicare services in 2024 · #2161 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.
61798 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
61797 is for each additional simple lesion. For additional complex lesions treated with 61798, use 61799 instead.
No office rate
61798 reports the first complex lesion in the session; 61799 reports each additional complex lesion.
Compare 61798 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$1336.00
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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 61798 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,891
- Code
- 61798
- Physician work
- 19.35
- Practice expense
- 12.76
- Malpractice
- 7.96
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.35 | × 1.019 | 19.7176 |
| Practice expense | 12.76 | × 1.033 | 13.1811 |
| Malpractice | 7.96 | × 0.892 | 7.1003 |
| Total RVUs | 39.9990 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1336.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.35 | 1.019 |
| Practice expense | 12.76 | 1.033 |
| Malpractice | 7.96 | 0.892 |
(19.35 × 1.019 + 12.76 × 1.033 + 7.96 × 0.892) × $33.4009 = $1336.00
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.
61798 billing questions
How is 61798 distinguished from 61796?
61798 is for a complex cranial lesion; 61796 is the corresponding simple-lesion code. Use the documented CPT complexity classification rather than assuming that lesion size, location, or count alone determines the level.
How are multiple complex lesions reported?
Report 61798 for the first complex lesion treated in the session and 61799 for each additional complex lesion. Document the targets and which lesions are additional.
Should modifier 50 be used for lesions on both sides?
No. Bilateral adjustment is not appropriate for this code; report applicable additional-lesion services using the complex-lesion sequence.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after the procedure.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment 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.
6,88861791,,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
6,89161798,,Srs cranial lesion complex,A,,19.35,12.76,NA,12.76,,7.96,40.07,40.07,0,090,0.11,0.76,0.13,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,89261799,,Srs cran les complex addl,A,,4.69,1.63,NA,1.63,,1.93,8.25,8.25,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,89361800,,Apply srs headframe add-on,A,,2.19,1.25,NA,1.25,,0.92,4.36,4.36,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,89461850,,Implant neuroelectrodes,A,,13.01,11.15,NA,11.15,,5.48,29.64,29.64,0,090,0.11,0.76,0.13,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537