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 – C71.9Malignant neoplasm of brain
C79.31Secondary malignant neoplasm of brain
C79.32Secondary 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
0278Medical/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-DRGDescription
023Craniotomy 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
DESCRIPTIONWORK
RVUs
AVERAGE
MEDICARE
PAYMENT
Evaluation and Management
99205Office outpatient, new patient3.50$176
Treatment Planning
77263Therapeutic radiology treatment planning; complex3.14$165
77470Radiation Treatment Management - Special treatment procedure2.03$104
Radiation Treatment Delivery (in the OR immediately following craniotomy)
77370Special medical physics consultation0.00$146
77778Interstitial radiation source application; complex, supervision, handling, loading of radiation source, when performed 8.78$451
Post Procedure Isodose/Dosimetry
772953-dimensional radiotherapy plan, including dose-volume histograms4.29$220
77300Basic radiation dosimetry calculation0.62$32
Total22.36$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
DESCRIPTIONWORK
RVUs
AVERAGE
MEDICARE
PAYMENT
Primary Procedure Codes
61510Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor30.83$2,181
61512Craniectomy, trephination, bone flap craniotomy; for excision of meningioma37.14$2,520
61518Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull39.89$2,735
61519Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma43.43$2,905
61520Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor57.09$3,661
61521Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull46.99$3,119
61526Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor54.08$3,265
61530Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy45.56$3,026
Add-On Codes
+61781Stereotactic computer-assisted (navigational) procedure; cranial, intradural3.75$230
+69990Microsurgical techniques, requiring use of operating microscope3.46$212
Total362.22$23,854

Contact us

To access these support services please contact our reimbursement team or your GammaTile Representative.