CPT 61651
Global ZZZ ActiveEvasc prlng admn rx agnt add
CPT 61651 Billing & Documentation Guide
CPT code 61651 (Evasc prlng admn rx agnt add) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.14, a non-facility practice expense RVU of 1.19, and a malpractice RVU of 1.37, a total non-facility RVU of 6.7 and facility RVU of 6.7. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $221.75, though rates vary from $190.45 to $295.38 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61651, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 61651 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 61651 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 61651
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.14 | 4.14 |
| Practice Expense RVU | 1.19 | 1.19 |
| Malpractice RVU | 1.37 | 1.37 |
| Total RVU | 6.7 | 6.7 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61651
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $215.08 | $215.08 | $208.72 - $235.33 | 29 |
| Florida | $267.24 | $267.24 | $245.05 - $295.38 | 3 |
| Georgia | $231.16 | $231.16 | $228.28 - $234.03 | 2 |
| Illinois | $264.62 | $264.62 | $246.09 - $284.21 | 4 |
| Michigan | $240.01 | $240.01 | $226.23 - $253.79 | 2 |
| North Carolina | $204.6 | $204.6 | $204.6 - $204.6 | 1 |
| New York | $251.39 | $251.39 | $208.21 - $279.36 | 5 |
| Ohio | $220.69 | $220.69 | $220.69 - $220.69 | 1 |
| Pennsylvania | $227.38 | $227.38 | $218.01 - $236.74 | 2 |
| Texas | $220.68 | $220.68 | $214.47 - $241.82 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 61651
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61651 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0632T | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 0645T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 61651
What does CPT code 61651 mean? +
CPT code 61651 represents: Evasc prlng admn rx agnt add. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 61651? +
The 2026 Medicare national average non-facility payment for CPT 61651 is $221.75. Rates range from $190.45 to $295.38 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61651? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 61651? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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