Billing code 61645: Intracranial thrombectomyMedicare rate & RVUs in Washington
Reports catheter-based treatment of an intracranial arterial clot by mechanical removal, thrombolytic infusion, or both, commonly during acute ischemic stroke care.
CMS doesn’t publish an office rate for 61645 in Washington.
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 61645 covers
A neurointerventional physician, endovascular neurosurgeon, or other qualified specialist uses an arterial catheter to treat a clot in an intracranial artery. Treatment may involve aspiration or a retrieval device to remove the clot, infusion of a thrombolytic agent, or both. The service is most often performed in a hospital angiography suite for an acute ischemic stroke caused by an intracranial arterial occlusion.
Report the service when the record supports intracranial clot treatment and identifies the target artery, occlusion, technique, and imaging findings. The code includes procedural imaging, radiological supervision and interpretation, and associated professional services. It has a 0-day global period, so same-day preoperative and postoperative care are included. CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery payment requires documentation of 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.
Where 61645 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $734.34 |
| Seattle (King Cnty) | Unavailable | $781.93 |
How the 61645 rate is calculated
Each of 61645’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 · 61645
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.63Practice expense 3.69Malpractice 4.31
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 61645
The CMS indicators that decide how 61645 is paid alongside other services.
CMS payment indicators · 61645
Intracranial thrombectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
61645 without 50 · national facility
$755.86
Intracranial thrombectomy
61645-50 · Bilateral: 150%
$1,133.79
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).
61645 compared with similar codes
Compare codes
61645 vs 61624 vs 61630 vs 61635 vs 61640: national Medicare rates
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How to choose
- 61624CNS embolization
- 61645 restores flow by treating an intracranial clot. Code 61624 is for catheter-based permanent occlusion or embolization in the central nervous system.
- 61630Balo angioplasty icr perq
- Use 61645 for mechanical thrombectomy or thrombolytic treatment of an intracranial clot; 61630 addresses intracranial arterial narrowing with balloon angioplasty.
- 61635Intracran angioplsty w/stent
- 61635 covers intracranial angioplasty with stent placement for stenosis. It is distinct from 61645, which treats an arterial clot.
- 61640Dilate ic vasospasm init
- 61640 treats intracranial vasospasm with dilation. Choose 61645 when the target is an intracranial arterial clot.
61645 billing questions
When should 61645 be chosen instead of intracranial angioplasty?
Use 61645 for catheter-based treatment of an intracranial arterial clot. Angioplasty codes address vessel narrowing rather than clot removal.
Does 61645 include the procedural imaging?
Yes. The code includes imaging and radiological supervision and interpretation associated with the thrombectomy or thrombolytic infusion.
What should the procedure note document?
Document the intracranial artery and occlusion treated, the imaging findings, and whether the physician used mechanical clot removal, thrombolytic infusion, or both.
How is bilateral performance reported?
When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral service at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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 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
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