How much does Medicare pay for CPT 61796?

Medicare allowed an average of $1039.54 per service and paid $829.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7088.52, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 61796?

Computer-assisted radiosurgery of simple growth of brain, first growth. It was billed 3,534 times to 3,120 Medicare beneficiaries by 136 providers in 2024.

Does 61796 pay differently in an office than a hospital?

Yes. The allowed amount averaged $999.86 in an office setting and $1041.37 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 61796 most?

Neurosurgery, with 3,404 services from 131 clinicians. Next are Neurology, Critical Care (Intensivists), Nurse Practitioner.

CPT 61796

Computer-assisted radiosurgery of simple growth of brain, first growth

$1039.54Medicare-allowed amount per service, averaged across 3,534 services

Providers submitted

$7088.52

Asking price, not received

Medicare allowed

$1039.54

The fee schedule figure

Medicare paid

$829.25

Balance is patient coinsurance

Providers submitted an average of $7088.52 for this code and Medicare allowed $1039.54 — 6.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $829.25 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $999.86
Hospital / facility: $1041.37

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 156 services were billed in an office setting and 3,378 in a facility.

Services: 3,534
Beneficiaries: 3,120
Providers billing it: 136
Total allowed: $3,673,734

What Medicare pays for CPT 61796

Across 3,534 services billed by 136 providers to 3,120 beneficiaries, Medicare allowed an average of $1039.54 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 61796

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	3,404	3,027	$1045.06	131
Neurology	72	45	$980.45	2
Critical Care (Intensivists)	27	21	$1001.19	1
Nurse Practitioner	16	13	$178.50	1
Anesthesiology	15	14	$1057.46	1

61796 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	401	$1081.27	$807.77	15
Texas	390	$1046.12	$806.63	13
New York	335	$1154.08	$804.19	10
Ohio	277	$990.85	$810.84	8
Massachusetts	252	$1072.03	$811.85	6
Pennsylvania	216	$1024.51	$809.14	11
Florida	215	$1103.37	$756.95	10
North Carolina	181	$925.42	$806.70	9
Virginia	141	$970.84	$808.58	4
Colorado	127	$966.25	$810.21	4
Illinois	113	$1197.73	$801.99	7
Minnesota	109	$939.24	$810.36	3
New Jersey	87	$1141.78	$783.01	4
Missouri	70	$991.82	$807.98	3
Maryland	69	$1085.44	$808.84	4
South Carolina	65	$952.70	$810.90	2
Washington	55	$1082.32	$808.09	2
Mississippi	50	$874.24	$794.10	3
Utah	49	$972.13	$790.98	2
Connecticut	48	$1103.58	$811.00	1
Wisconsin	41	$943.29	$809.38	2
Kentucky	34	$955.06	$816.85	2
Tennessee	30	$803.06	$814.74	2
Alabama	26	$895.55	$779.74	1
South Dakota	24	$882.65	$817.35	1
Montana	23	$1003.50	$811.79	1
West Virginia	20	$1058.03	$811.61	1
Louisiana	20	$978.44	$812.02	1
New Hampshire	20	$956.59	$818.45	1
Arkansas	18	$956.17	$822.75	1
Arizona	15	$1020.52	$811.16	1
Rhode Island	13	$998.49	$802.90	1

Related codes

61783Computer-assisted spinal procedure$211.81
61782Computer-assisted procedure outside membrane covering brain$167.85
61781Computer-assisted procedure inside brain$235.29
61797Computer-assisted radiosurgery of simple growth of brain$222.21
61798Computer-assisted radiosurgery of complex growth of brain$1414.29

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.