CPT 61796
Global 090 ActiveSrs cranial lesion simple
CPT 61796 Billing & Documentation Guide
CPT code 61796 (Srs cranial lesion simple) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 13.58, a non-facility practice expense RVU of 11.06, and a malpractice RVU of 5.68, a total non-facility RVU of 30.32 and facility RVU of 30.32. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1010.77, though rates vary from $865.92 to $1317.94 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61796, 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 61796 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 61796 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 61796
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 13.58 | 13.58 |
| Practice Expense RVU | 11.06 | 11.06 |
| Malpractice RVU | 5.68 | 5.68 |
| Total RVU | 30.32 | 30.32 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61796
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 | $1009.85 | $1009.85 | $967.86 - $1137.86 | 29 |
| Florida | $1193.55 | $1193.55 | $1091.89 - $1317.94 | 3 |
| Georgia | $1033.68 | $1033.68 | $1009.24 - $1058.12 | 2 |
| Illinois | $1174.67 | $1174.67 | $1087.39 - $1263.42 | 4 |
| Michigan | $1067.49 | $1067.49 | $1005.05 - $1129.93 | 2 |
| North Carolina | $919.48 | $919.48 | $919.48 - $919.48 | 1 |
| New York | $1145.14 | $1145.14 | $937.9 - $1274.15 | 5 |
| Ohio | $982.09 | $982.09 | $982.09 - $982.09 | 1 |
| Pennsylvania | $1022.32 | $1022.32 | $971.99 - $1072.64 | 2 |
| Texas | $995.99 | $995.99 | $966 - $1085.09 | 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 61796
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61796 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0073T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0197T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0398T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 61796
What does CPT code 61796 mean? +
CPT code 61796 represents: Srs cranial lesion simple. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 61796? +
The 2026 Medicare national average non-facility payment for CPT 61796 is $1010.77. Rates range from $865.92 to $1317.94 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61796? +
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 61796? +
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 May 31, 2026.
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