No office rate
61796 reports the first simple cranial lesion; 61797 reports each additional simple lesion in the same treatment context.
On this page
CMS RVU26D · Effective 2026-10-01
61796 Cranial radiosurgery Medicare reimbursement rates in Vermont
Reports stereotactic radiosurgery for one simple cranial lesion, such as an arteriovenous malformation or benign tumor, using focused radiation rather than open resection. Compare 61796 office and facility rates across CMS payment localities in Vermont.
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 61796 in Vermont?
Vermont 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
$915.30
1 of 1 localities have a supported rate.
Payment area: Vermont
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 61796: Stereotactic radiosurgery for a simple cranial lesion
Reports stereotactic radiosurgery for one simple cranial lesion, such as an arteriovenous malformation or benign tumor, using focused radiation rather than open resection.
This service delivers focused radiation to a defined intracranial target using stereotactic localization. It is used for a simple cranial lesion, including an arteriovenous malformation or benign tumor, and is commonly provided through a hospital or radiation oncology setting by a physician involved in radiosurgery, such as a radiation oncologist or neurosurgeon. Frame placement, when performed as part of the service, is included.
Report 61796 for the first simple lesion; report 61797 for each additional simple lesion. Documentation should identify the target and support its simple-lesion classification, and record the stereotactic treatment provided. CMS assigns this major surgery a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. An assistant at surgery may be paid. Modifier 50 is inappropriate; co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 61796
- 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 RVU13.58 · 45%
- Practice expense (office) RVU11.06 · 36%
- Malpractice RVU5.68 · 19%
5.8K
Medicare services in 2024 · #1775 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.
61796 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Choose 61798 when the cranial lesion is classified as complex rather than simple; lesion complexity, not merely the number of targets, distinguishes the codes.
No office rate
61799 reports an additional complex lesion with the complex-lesion service. It is not the add-on for additional simple lesions; use 61797 for those.
Compare 61796 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
Vermont →
Office / nonfacility
Unavailable
Facility
$915.30
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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 61796 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,889
- Code
- 61796
- Physician work
- 13.58
- Practice expense
- 11.06
- Malpractice
- 5.68
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.58 | × 1.000 | 13.5800 |
| Practice expense | 11.06 | × 0.990 | 10.9494 |
| Malpractice | 5.68 | × 0.506 | 2.8741 |
| Total RVUs | 27.4035 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$915.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.58 | 1 |
| Practice expense | 11.06 | 0.99 |
| Malpractice | 5.68 | 0.506 |
(13.58 × 1 + 11.06 × 0.99 + 5.68 × 0.506) × $33.4009 = $915.30
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.
61796 billing questions
When should 61796 be chosen instead of 61798?
Use 61796 for a simple cranial lesion, such as an arteriovenous malformation or benign tumor. Use 61798 when the lesion is classified as complex.
How are additional simple lesions reported?
Report 61796 for the first simple lesion and 61797 for each additional simple lesion treated.
Is frame placement separately reported?
Frame placement, when performed as part of this radiosurgery service, is included in 61796.
What global period applies?
CMS assigns a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeon or team-surgery payment for this code.
Should modifier 50 be used for bilateral targets?
No. CMS identifies bilateral adjustment as inappropriate for 61796; report additional simple lesions using the applicable add-on code instead.
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.
6,88661783,,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
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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817