Summary & Overview
CPT 61892: Removal of Intracranial Neurostimulator, Possible Cranioplasty
CPT code 61892 represents the surgical removal of a small intracranial neurostimulator pulse generator or receiver, often performed with cranioplasty to repair the skull defect. This code captures a specialized neurosurgical explantation procedure relevant to hospitals and neurosurgical practices nationwide as intracranial neuromodulation devices are increasingly used for refractory neurologic conditions. The code matters nationally for accurate clinical reporting, device management workflows, and payer coverage determinations for complex neurosurgical care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of clinical context and typical sites of service, common procedural considerations tied to explantation and cranioplasty, and what to expect in payer coverage and billing practice. The publication also outlines benchmarks where available, coding nuances, and recent policy or reimbursement updates that affect hospital and outpatient billing for intracranial device removal.
This summary is intended for coding professionals, revenue cycle leaders, and clinical teams seeking a clear national perspective on how CPT code 61892 is used, billed, and adjudicated across major payers.
Billing Code Overview
CPT code 61892 describes the removal of a small neurostimulator pulse generator or receiver from the skull, a neurosurgical procedure that may include cranioplasty to reattach a piece of skull or fill a skull defect. The procedure involves explantation of an implanted intracranial neurostimulation device and any necessary reconstruction of the skull defect created by device removal.
-
Service type: Surgical explantation of intracranial neurostimulator with possible cranioplasty
-
Typical site of service: Inpatient or outpatient hospital surgical setting, including operating room for neurosurgical procedures
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with an implanted cortical neurostimulator receiver/pulse generator in the skull presents for elective removal due to device malfunction and recurrent infection at the implant site. Preoperative evaluation includes device interrogation by neuromodulation clinic staff, neurologic exam, head CT to assess device position and surrounding bone integrity, and labs to rule out active systemic infection. The procedure is performed in an operating room under general anesthesia by a neurosurgeon. The surgeon removes the small skull-mounted pulse generator/receiver, inspects the surrounding bone and soft tissues, cultures any purulent material, and performs immediate cranioplasty if a bone flap or skull reconstruction is required. Postoperative workflow includes wound care instructions, short inpatient observation for pain control and neurologic monitoring when indicated, coordination with the device manufacturer for explant documentation, updating the patient’s implant records, and scheduling follow-up with neurology and infectious disease if infection was present. Billing reflects the explant procedure for the skull-mounted neurostimulator pulse generator/receiver (61892) and may include additional CPT codes for cranioplasty or wound management if performed separately and supported by operative documentation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |