61797 Srs cran les simple addl
What 61797 is
CMS fee schedule short descriptor: Srs cran les simple addl.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 61797 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.39 | 1.18 | 1.42 | 5.99 | $200.07 |
| Facility (hospital, ASC) | 3.39 | 1.18 | 1.42 | 5.99 | $200.07 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 61797 at 4 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 61797? These codes are bundled into it
61797 is a Column 1 code in 10 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
61781 | Scan proc cranial intra | 1 - modifier may bypass | Check pair |
61782 | Scan proc cranial extra | 1 - modifier may bypass | Check pair |
95863 | Needle emg 3 extremities | 0 - no modifier bypass | Check pair |
95864 | Needle emg 4 extremities | 0 - no modifier bypass | Check pair |
95865 | Needle emg larynx | 0 - no modifier bypass | Check pair |
95866 | Needle emg hemidiaphragm | 0 - no modifier bypass | Check pair |
95869 | Ndl emg thrc paraspinal musc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
61797 is bundled into these codes
61797 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 61797 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
61720 | Incise skull/brain surgery | 1 | Check pair |
61735 | Incise skull/brain surgery | 1 | Check pair |
61736 | Litt icr 1 traj 1 smpl les | 1 | Check pair |
61737 | Litt icr mlt trj mlt/cplx ls | 1 | Check pair |
61770 | Incise skull for treatment | 1 | Check pair |
61790 | Treat trigeminal nerve | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.