GammaTile reimbursement
Navigating
reimbursement, billing,
and coding for GammaTile® Therapy
At GT Medical Technologies, we’re here to support you – not just with innovative care, but with clear guidance on reimbursement.
GammaTile coding
at a glance
- Code the GammaTile procedure to ICD-10 procedure code 00H004Z (Insertion of Radioactive Element, Cesium-131 Collagen Implant into Brain, Open Approach).
- When reported in combination with the relevant craniotomy ICD-10-PCS code, Medicare payment will be made under MS-DRG 023.
- Update your hospital’s chargemaster (CDM) and assign GammaTile to Revenue Code 0278 (OR Supplies Implant) so GammaTile can be charged to the OR rather than the Radiation Therapy department.
Hospital inpatient (surgery)
Hospital inpatient procedures and services are based on the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS), which utilizes the Medicare Severity Diagnosis Related Group (MS-DRG) system.
Inpatient coding
GammaTile is implanted in the OR during tumor resection (via a craniotomy), in the inpatient setting where ICD-10 procedure and diagnosis codes apply.
| ICD-10 Commonly Reported Diagnosis Codes | |
|---|---|
| C71.0 – C71.9 | Malignant neoplasm of brain |
| C79.31 | Secondary malignant neoplasm of brain |
| C79.32 | Secondary malignant neoplasm of cerebral meninges |
| ICD-10 Procedure Code (also code craniotomy and all other procedures, as performed) | |
| 00H004Z* | Insertion of Radioactive Element, Cesium-131 Collagen Implant into Brain, Open Approach |
| * For GammaTile to map to the appropriate DRG (DRG 023), it is necessary to code the insertion of GammaTile (Cesium-131) using ICD-10 procedure code 00H004Z. | |
| Hospital Revenue Code for GammaTile | |
| 0278 | Medical/Surgical Supplies and Devices |
Inpatient payment
| MS-DRG payment information | |
|---|---|
| For FY 2025, ICD-10-PCS 00H004Z maps to MS-DRG 023, which is listed below. | |
| MS-DRG | Description |
| 023 | Craniotomy with Major Device Implant or Acute Complex Central Nervous System Principal Diagnosis with MCC or Chemotherapy Implant |
Physician services
The following CPT® codes represent procedures that may be commonly associated with GammaTile
Radiation oncology/physics
NOTE: This is not an exhaustive list of all potential CPT codes that may be appropriate for each patient. Providers should only bill for actual procedures performed and documented in the patient’s medical record. Providers should check with the patient’s health plan for instructions on specific pre-authorization, billing and documentation requirements. Average payments noted are the Medicare 2025 national averages. The actual payments vary based on the provider’s location.
| CPT® CODES | DESCRIPTION | WORK RVUs | AVERAGE MEDICARE PAYMENT |
|---|---|---|---|
| Evaluation and Management | |||
| 99205 | Office outpatient, new patient | 3.50 | $176 |
| Treatment Planning | |||
| 77263 | Therapeutic radiology treatment planning; complex | 3.14 | $165 |
| 77470 | Radiation Treatment Management - Special treatment procedure | 2.03 | $104 |
| Radiation Treatment Delivery (in the OR immediately following craniotomy) | |||
| 77370 | Special medical physics consultation | 0.00 | $146 |
| 77778 | Interstitial radiation source application; complex, supervision, handling, loading of radiation source, when performed | 8.78 | $451 |
| Post Procedure Isodose/Dosimetry | |||
| 77295 | 3-dimensional radiotherapy plan, including dose-volume histograms | 4.29 | $220 |
| 77300 | Basic radiation dosimetry calculation | 0.62 | $32 |
| Total | 22.36 | $1,294 | |
GammaTile workflow
Neurosurgery
NOTE: This is not an exhaustive list of all potential CPT codes that may be appropriate for each patient. Providers should only bill for actual procedures performed and documented in the patient’s medical record. Providers should check with the patient’s health plan for instructions on specific pre-authorization, billing and documentation requirements. Average payments noted are the Medicare 2025 national averages. The actual payments vary based on the provider’s location.
| CPT® CODES | DESCRIPTION | WORK RVUs | AVERAGE MEDICARE PAYMENT |
|---|---|---|---|
| Primary Procedure Codes | |||
| 61510 | Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor | 30.83 | $2,181 |
| 61512 | Craniectomy, trephination, bone flap craniotomy; for excision of meningioma | 37.14 | $2,520 |
| 61518 | Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull | 39.89 | $2,735 |
| 61519 | Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma | 43.43 | $2,905 |
| 61520 | Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor | 57.09 | $3,661 |
| 61521 | Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull | 46.99 | $3,119 |
| 61526 | Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor | 54.08 | $3,265 |
| 61530 | Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy | 45.56 | $3,026 |
| Add-On Codes | |||
| +61781 | Stereotactic computer-assisted (navigational) procedure; cranial, intradural | 3.75 | $230 |
| +69990 | Microsurgical techniques, requiring use of operating microscope | 3.46 | $212 |
| Total | 362.22 | $23,854 | |
Contact us
To access these support services please contact our reimbursement team or your GammaTile Representative.