CPT 61867
Global 090 ActiveImplant neuroelectrode
CPT 61867 Billing & Documentation Guide
CPT code 61867 (Implant neuroelectrode) 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 32.2, a non-facility practice expense RVU of 20.26, and a malpractice RVU of 13.6, a total non-facility RVU of 66.06 and facility RVU of 66.06. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $2192.51, though rates vary from $1863.7 to $2928.76 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 61867, 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 61867 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 61867 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 61867
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 32.2 | 32.2 |
| Practice Expense RVU | 20.26 | 20.26 |
| Malpractice RVU | 13.6 | 13.6 |
| Total RVU | 66.06 | 66.06 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 61867
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 | $2161.13 | $2161.13 | $2078.94 - $2413.1 | 29 |
| Florida | $2638.75 | $2638.75 | $2405.18 - $2928.76 | 3 |
| Georgia | $2266.21 | $2266.21 | $2220.6 - $2311.82 | 2 |
| Illinois | $2601.21 | $2601.21 | $2403.33 - $2805.63 | 4 |
| Michigan | $2350.3 | $2350.3 | $2206.19 - $2494.4 | 2 |
| North Carolina | $1997.14 | $1997.14 | $1997.14 - $1997.14 | 1 |
| New York | $2499.02 | $2499.02 | $2037.72 - $2792.49 | 5 |
| Ohio | $2151.22 | $2151.22 | $2151.22 - $2151.22 | 1 |
| Pennsylvania | $2233.62 | $2233.62 | $2125.99 - $2341.24 | 2 |
| Texas | $2169.58 | $2169.58 | $2109.04 - $2381.13 | 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 61867
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 61867 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0082T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 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 | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0282T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0283T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0398T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 61867
What does CPT code 61867 mean? +
CPT code 61867 represents: Implant neuroelectrode. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 61867? +
The 2026 Medicare national average non-facility payment for CPT 61867 is $2192.51. Rates range from $1863.7 to $2928.76 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 61867? +
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 61867? +
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 2, 2026.
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