No office rate
61751 is the stereotactic biopsy option when CT or MR guidance is used. This code is for a brain biopsy without that guidance.
On this page
CMS RVU26D · Effective 2026-10-01
61750 Brain biopsy Medicare reimbursement rates in Utah
A neurosurgeon obtains brain tissue through a burr hole or trephine for diagnosis when the biopsy is performed without CT or MR guidance. Compare 61750 office and facility rates across CMS payment localities in Utah.
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 61750 in Utah?
Utah 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
$1329.69
1 of 1 localities have a supported rate.
Payment area: Utah
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 61750: Brain biopsy through burr hole
A neurosurgeon obtains brain tissue through a burr hole or trephine for diagnosis when the biopsy is performed without CT or MR guidance.
The neurosurgeon creates a small opening in the skull with a burr hole or trephine and takes a sample of brain tissue for diagnosis. This service is typically performed in an operating room, often in a hospital, to investigate an intracranial lesion or other abnormal brain finding. The sample is sent for pathologic examination; the surgeon reports the operative biopsy, not the pathologist’s interpretation.
Select this code when the operative report supports a brain biopsy through a skull opening without the CT or MR guidance associated with the stereotactic biopsy alternative. Document the target, approach, tissue obtained, and any dural opening. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 61750
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.33 · 47%
- Practice expense (office) RVU14.03 · 34%
- Malpractice RVU8.12 · 20%
1K
Medicare services in 2024 · #2961 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.
61750 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Choose 61720 when the operative service is treatment of a brain lesion rather than biopsy for tissue diagnosis.
No office rate
This code is for brain biopsy; 61735 represents an operative brain procedure rather than tissue sampling for diagnosis.
Compare 61750 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
Utah →
Office / nonfacility
Unavailable
Facility
$1329.69
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 61750 in Utah.
PPRRVU2026_Oct_nonQPP.csv
6,880
- Code
- 61750
- Physician work
- 19.33
- Practice expense
- 14.03
- Malpractice
- 8.12
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.33 | × 1.000 | 19.3300 |
| Practice expense | 14.03 | × 0.940 | 13.1882 |
| Malpractice | 8.12 | × 0.898 | 7.2918 |
| Total RVUs | 39.8100 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$1329.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.33 | 1 |
| Practice expense | 14.03 | 0.94 |
| Malpractice | 8.12 | 0.898 |
(19.33 × 1 + 14.03 × 0.94 + 8.12 × 0.898) × $33.4009 = $1329.69
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.
61750 billing questions
When should 61751 be reported instead?
Use 61751 when the brain biopsy is performed with CT or MR guidance. This code describes the biopsy without that guidance.
Can separate brain biopsy codes be reported for multiple tissue samples?
The code describes the biopsy procedure, not each specimen. Document the target and samples obtained; multiple specimens alone do not establish separate procedures.
Does the 90-day global period include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for biopsies on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted. Co-surgeon payment is allowed only with supporting documentation; team surgery is not permitted.
How does CMS handle this code with other procedures in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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.
6,87761735,,Incise skull/brain surgery,A,,21.79,16.06,NA,16.06,,9.19,47.04,47.04,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,87861736,,Litt icr 1 traj 1 smpl les,A,,18.58,7.75,NA,7.75,,7.85,34.18,34.18,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,87961737,,Litt icr mlt trj mlt/cplx ls,A,,22.10,8.99,NA,8.99,,9.33,40.42,40.42,0,000,0.00,0.00,0.00,0,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88061750,,Incise skull/brain biopsy,A,,19.33,14.03,NA,14.03,,8.12,41.48,41.48,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88161751,,Brain biopsy w/ct/mr guide,A,,18.32,15.49,NA,15.49,,7.70,41.51,41.51,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88261760,,Implant brain electrodes,A,,21.83,15.49,NA,15.49,,9.21,46.53,46.53,0,090,0.11,0.76,0.13,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,88361770,,Incise skull for treatment,A,,22.61,15.29,NA,15.29,,9.55,47.45,47.45,0,090,0.11,0.76,0.13,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985