Does 61641 require prior authorization?

No, 61641 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 61641?

Medicare facility rate: $164.33. Non-facility rate: $164.33. Work RVU: 4.33.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

4.33

Facility

$164.33

Non-Facility

$164.33

Extracranial Stent Placement with or without Angioplasty:
Extracranial carotid artery stent placement with or without angioplasty is consideredmedically necessaryfor individuals who meet EITHER A or B of the following criteriaandcan be safely treated by this approachandwho have no angiographically visible intraluminal thrombus:
Symptomatic stenosis equal to or greater than 50%,orasymptomatic stenosis equal to or greater than 80%;andOne ormoreof the following conditions which put the individual at a high risk or unsuitable for surgery:Congestive heart failure (NYHA Class III/IV) or left ventricular ejection fraction less than 30%;orOpen heart surgery needed within the next 6 weeks;orRecent myocardial infarction (greater than 24 hours and less than 4 weeks);orSevere chronic obstructive pulmonary disease;orUnstable angina [...]
Congestive heart failure (NYHA Class III/IV) or left ventricular ejection fraction less than 30%;or
Open heart surgery needed within the next 6 weeks;or
Recent myocardial infarction (greater than 24 hours and less than 4 weeks);or

ANTHEM-CG-SURG-76 — CG-SURG-76 Carotid, Vertebral and Intracranial Artery Stent Placement with or without Angioplasty

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