CPT 61800
Global ZZZ ActiveApply srs headframe add-on
CPT 61800 Billing & Documentation Guide
CPT code 61800 (Apply srs headframe add-on) 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 2.19, a non-facility practice expense RVU of 1.25, and a malpractice RVU of 0.92, a total non-facility RVU of 4.36 and facility RVU of 4.36. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $144.52, though rates vary from $122.61 to $194.32 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61800, 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 61800 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 1 units of 61800 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 61800
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.19 | 2.19 |
| Practice Expense RVU | 1.25 | 1.25 |
| Malpractice RVU | 0.92 | 0.92 |
| Total RVU | 4.36 | 4.36 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61800
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 | $141.84 | $141.84 | $136.62 - $157.87 | 29 |
| Florida | $174.86 | $174.86 | $159.25 - $194.32 | 3 |
| Georgia | $149.86 | $149.86 | $147.02 - $152.69 | 2 |
| Illinois | $172.47 | $172.47 | $159.3 - $186.14 | 4 |
| Michigan | $155.61 | $155.61 | $145.96 - $165.25 | 2 |
| North Carolina | $131.74 | $131.74 | $131.74 - $131.74 | 1 |
| New York | $164.97 | $164.97 | $134.41 - $184.53 | 5 |
| Ohio | $142.24 | $142.24 | $142.24 - $142.24 | 1 |
| Pennsylvania | $147.55 | $147.55 | $140.51 - $154.59 | 2 |
| Texas | $143.2 | $143.2 | $139.08 - $157.47 | 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 61800
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61800 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 20660 | Column 1 (primary), can be billed with modifier | No | CPT Separate procedure definition |
| 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 | No | 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 61800
What does CPT code 61800 mean? +
CPT code 61800 represents: Apply srs headframe add-on. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 61800? +
The 2026 Medicare national average non-facility payment for CPT 61800 is $144.52. Rates range from $122.61 to $194.32 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61800? +
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 61800? +
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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