2025 CPT code 61860
(Active) Effective Date: N/A Revision Date: N/A Surgery - Craniotomy/Craniectomy Nervous System Feed
Craniotomy or craniectomy for neurostimulator electrode implantation in the cerebral cortex.
Modifiers may be applicable depending on the circumstances. For example, modifier 51 (multiple procedures) might be used if other procedures were done at the same surgical session.Consult the most recent CPT guidelines and local payer guidelines.
Medical necessity is established through documentation of failed medical management of the underlying neurological condition (e.g., medically refractory epilepsy, essential tremor), comprehensive evaluation, and detailed justification for the procedure's benefit.
The neurosurgeon is responsible for performing the craniotomy or craniectomy, placing the electrodes precisely on the cerebral cortex, testing electrode placement and functionality, and closing the incision.
In simple words: The doctor opens a part of the skull to place small electrodes on the surface of the brain to help treat a neurological condition.This involves removing a piece of skull bone, placing the electrodes, and then closing the opening.
This procedure involves a craniotomy or craniectomy to access the cerebral cortex for the implantation of neurostimulator electrodes.The surgeon removes a portion of the skull bone to expose the brain's surface.Electrodes are precisely placed on the cerebral cortex, followed by testing to confirm correct placement and functionality. The skull bone may then be replaced and the incision closed.
Example 1: A patient with medically refractory epilepsy undergoes a craniotomy for implantation of a cortical neurostimulator to control seizures.Code 61860 would be used to bill for the surgical procedure itself., A patient with essential tremor undergoes deep brain stimulation surgery.A craniotomy is performed to implant electrodes in the thalamus. The appropriate codes for the deep brain stimulation along with 61860 would be reported if this is performed., During a revision surgery for a previously implanted neurostimulator, the surgeon performs a craniotomy to access and replace malfunctioning electrodes on the cortex.Code 61860 is billed for the craniotomy and electrode replacement. The replacement of the pulse generator may require an additional code.
Detailed operative notes describing the craniotomy/craniectomy technique, electrode placement locations (with coordinates if applicable), testing of electrode function and location, and closure of the incision.Preoperative imaging (MRI or CT scan) showing the target location, and intraoperative images confirming electrode placement, are also required.
** The specific type of craniotomy (e.g., craniectomy, craniotomy) should be documented in the operative report.Intraoperative neurophysiological monitoring, if performed by a separate individual, might require additional coding.RVU values are subject to change; always refer to the most current local fee schedule.
- Revenue Code: 0360 (Surgical procedures and services)
- RVU: The RVUs vary based on geographic location and facility type.Consult the appropriate fee schedule for the most up-to-date values.
- Global Days : The global period is dependent on the specific procedure and payer; check the payer's guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable.
- Fee Schedule : Historical fee schedule data should be obtained from payer-specific databases or published fee schedules.
- Specialties:Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center