CPT 61797
Global ZZZ ActiveSrs cran les simple addl
CPT 61797 Billing & Documentation Guide
CPT code 61797 (Srs cran les simple addl) 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 3.39, a non-facility practice expense RVU of 1.18, and a malpractice RVU of 1.42, a total non-facility RVU of 5.99 and facility RVU of 5.99. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $197.27, though rates vary from $165.59 to $274.21 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61797, 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 61797 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 4 units of 61797 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 61797
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.39 | 3.39 |
| Practice Expense RVU | 1.18 | 1.18 |
| Malpractice RVU | 1.42 | 1.42 |
| Total RVU | 5.99 | 5.99 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61797
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 | $189.64 | $189.64 | $183.77 - $207.94 | 29 |
| Florida | $245.1 | $245.1 | $222.19 - $274.21 | 3 |
| Georgia | $207.75 | $207.75 | $204.92 - $210.57 | 2 |
| Illinois | $242.35 | $242.35 | $223.35 - $262.48 | 4 |
| Michigan | $217 | $217 | $202.76 - $231.23 | 2 |
| North Carolina | $180.31 | $180.31 | $180.31 - $180.31 | 1 |
| New York | $227.05 | $227.05 | $184.01 - $255.41 | 5 |
| Ohio | $197.02 | $197.02 | $197.02 - $197.02 | 1 |
| Pennsylvania | $203.56 | $203.56 | $194.23 - $212.88 | 2 |
| Texas | $196.71 | $196.71 | $190.19 - $218.53 | 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 61797
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61797 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 61781 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 61782 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 95863 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95864 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95865 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95866 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 95869 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 61797
What does CPT code 61797 mean? +
CPT code 61797 represents: Srs cran les simple addl. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 61797? +
The 2026 Medicare national average non-facility payment for CPT 61797 is $197.27. Rates range from $165.59 to $274.21 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61797? +
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 61797? +
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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