61316
ActiveAdd-on codeInc&subq plmt crnl bone grf
61316 is an add-on code — it is only payable alongside a primary procedure: 61304, 61312, 61313, 61322, 61323, 61340, 61570, 61571, 61680, 61682, 61684, 61686, 61690, 61692, 61697, 61698, 61700, 61702, 61703, 61705.
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 61316 | 1 | $79.83 | $79.83 |
| add-on69990 | 0 | $198.07/ unit | $198.07/ unit |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 61316 | 1.36 | 0.47 | 0.47 | 0.56 | 2.39 |
Payment policy for 61316
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=0No reduction
No multiple-procedure payment adjustment applies (typical for add-on codes).
Bilateral (modifier 50)
bilt_surg=0150% rule doesn't apply
Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).
Assistant surgeon (80/81/82)
asst_surg=1Not payable
Assistant at surgery may not be paid for this procedure.
Co-surgeons (modifier 62)
co_surg=0Not permitted
Co-surgeons (mod 62) may not be paid for this procedure.
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.