Summary & Overview
CPT 61790: Stereotactic Percutaneous Gasserian Ganglion Lesioning
CPT code 61790 represents stereotactic percutaneous neurolytic lesioning of the gasserian ganglion, a targeted procedure used to relieve trigeminal or other cranial nerve–related pain by creating a focal lesion with a nerve-destroying agent. Nationally, this code matters for specialized pain management and neurosurgical practices, as it captures a high-complexity, image-guided destructive procedure that can affect utilization, coverage policy, and access to procedural pain therapies.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service settings, plus national benchmarking and payer coverage considerations where available. The publication outlines reimbursement and coding considerations, typical sites of service, and clinical scenarios that commonly drive use of this procedure. It also summarizes common modifiers and related administrative details provided in the input.
This resource is aimed at billing managers, practice administrators, and policy analysts seeking a clear, national-level reference for coding and payer considerations for CPT code 61790. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 61790 describes a stereotactic percutaneous procedure in which a provider uses a nerve-destroying agent to create a lesion in the gasserian ganglion at the root of the fifth cranial nerve to relieve pain that extends along a nerve or nerves. The technique employs a three-dimensional coordinate system to precisely target the ganglion.
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Service type: Stereotactic percutaneous neurolytic lesioning of the gasserian ganglion
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Typical site of service: Hospital outpatient department or ambulatory surgery center, with possible performance in specialized neurosurgical procedural suites
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with medically refractory trigeminal neuralgia presents to a neurosurgery service for percutaneous stereotactic radiofrequency lesioning of the gasserian (trigeminal) ganglion. The patient has a history of lancinating, unilateral facial pain in the distribution of the right maxillary and mandibular branches (V2–V3) that has failed optimized medical therapy including carbamazepine and baclofen and causes significant functional impairment. Pre-procedure evaluation includes focused neurologic exam, medication review, informed consent, and stereotactic imaging (CT or MRI) for trajectory planning.
On the day of service the patient is brought to a procedure suite or ambulatory surgery center. Conscious sedation or general anesthesia is administered per institutional protocol. Using stereotactic coordinates based on pre-procedure imaging, the surgeon advances a percutaneous cannula to the foramen ovale and places a radiofrequency/destructive agent needle into the gasserian ganglion. Intra-procedural neurologic testing (sensory stimulation) confirms correct localization prior to lesioning. The provider creates a thermocoagulation lesion to ablate pain fibers. Post-procedure, the patient is recovered in PACU with neurologic monitoring and discharged home the same day or admitted if complications occur. Follow-up includes pain assessment, wound check, and medication adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service |