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See a sample rate comparisonCPT 61026 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection Into Brain Canal, Ventricular Puncture Through Previous Burr Hole Fontanelle Suture Or Implanted Ventricular Catheter Reservoir With Injection Of Medication Or Other Substance For Diagnosis Or Treatment
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AG - Primary physician UA |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 61026 |
| Medicaid Fee Schedule | View Medicaid rates for 61026 |
National average reimbursement for CPT 61026 by major payers:
$164.31
$156.32
$159.09
$184.26
Compare published rates across providers.
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CPT 61026
5 of 25 sample ratesHigher to lower in this preview
Lindustries, LLC, Seventh Avenue Surgery Center
Lindustries LLC
$2,190.06Published rateMidwest Nephrology Associates, Sc, Mna Surgery Center
Midwest Nephrology Associates, Sc
$1,411.00Published rateBaptist Beaches Surgery Center LLC, Horizon Surgery Center Beaches
Baptist Beaches Surgery Center LLC
$719.00Published rateBoston Eye Surgery & Laser Center Trust, Boston Eye Surgery & Laser Center
Boston Eye Surgery & Laser Center Trust
$434.00Published rateChesapeake Ambulatory Surgery Center
$109.00Published rate
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See a sample payer proposalCPT 61026 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61026 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 61026 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 61020-CPT | Low | Create Opening In Skull, A Procedure To Create An Opening Into The Skull Through A Previous Opening Or Implanted Tube (Catheter). The Procedure May Involve Injection Of Medication Through The Opening. |
| 61026-CPT | Low | Injection Into Brain Canal, Ventricular Puncture Through Previous Burr Hole Fontanelle Suture Or Implanted Ventricular Catheter Reservoir With Injection Of Medication Or Other Substance For Diagnosis Or Treatment |
| 61105-CPT | Moderate | Puncture Ventric W Twist Drill |
| 61150-CPT | High | Drain Brain Cyst Or Infection, Surgery To Drain Abscess (Pocket Of Infection) Or Cyst (Fluid Filled Sac) Located In The Brain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61026. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61026 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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