No office rate
Choose 61791 when the operative target is the trigeminal tract; choose 61790 when the lesion is created in the trigeminal nerve.
On this page
CMS RVU26D · Effective 2026-10-01
61791 Trigeminal tract lesion Medicare reimbursement rates in Wisconsin
Reports stereotactic creation of a lesion in the trigeminal tract to interrupt facial pain transmission, typically for selected patients with severe, persistent facial pain. Compare 61791 office and facility rates across CMS payment localities in Wisconsin.
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 61791 in Wisconsin?
Wisconsin 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
$962.94
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 61791: Stereotactic trigeminal tract lesioning
Reports stereotactic creation of a lesion in the trigeminal tract to interrupt facial pain transmission, typically for selected patients with severe, persistent facial pain.
This code represents a stereotactic procedure that creates a lesion in the trigeminal tract to interrupt pain signals. It is distinct from lesioning the trigeminal nerve itself. Neurosurgeons typically perform the procedure in a hospital operating room for carefully selected patients with severe facial pain, such as pain that has not responded adequately to other treatment. The operative report should identify the tract target and describe the lesioning approach.
Report the code for the tract-targeting procedure, not for a procedure directed at the trigeminal nerve or for radiation treatment. Documentation should support the target, stereotactic method, indication, and work performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 61791
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.02 · 45%
- Practice expense (office) RVU12.38 · 37%
- Malpractice RVU6.33 · 19%
44
Medicare services in 2024 · #5439 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.
61791 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
61715
No office rateMrgfus strtctc ablt trgt icr
61715 describes stereotactic radiosurgery for a cranial nerve, with or without a brainstem lesion. 61791 involves surgically creating a lesion in the trigeminal tract.
No office rate
61796 is for stereotactic radiosurgery of a simple cranial lesion. It is not the tract-lesioning code for a procedure that creates a lesion in the trigeminal tract.
Compare 61791 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$962.94
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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 61791 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,888
- Code
- 61791
- Physician work
- 15.02
- Practice expense
- 12.38
- Malpractice
- 6.33
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.02 | × 1.000 | 15.0200 |
| Practice expense | 12.38 | × 0.958 | 11.8600 |
| Malpractice | 6.33 | × 0.308 | 1.9496 |
| Total RVUs | 28.8297 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$962.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.02 | 1 |
| Practice expense | 12.38 | 0.958 |
| Malpractice | 6.33 | 0.308 |
(15.02 × 1 + 12.38 × 0.958 + 6.33 × 0.308) × $33.4009 = $962.94
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.
61791 billing questions
How does this differ from 61790?
61791 is for lesioning the trigeminal tract. 61790 is for lesioning the trigeminal nerve; the operative target determines the code.
Can this be reported for stereotactic radiosurgery?
No. This code describes creation of a lesion in the trigeminal tract, not radiation treatment. For stereotactic radiosurgery directed at a cranial nerve, consider 61715 when its requirements are met.
What documentation supports reporting 61791?
The operative report should identify the trigeminal tract as the target, describe the stereotactic lesioning performed, and support the facial-pain indication.
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.
Can modifier 50 be used for a bilateral procedure?
CMS identifies this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
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.
6,88561782,,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,