A fixed high frequency oscillator, variable frequency divider, and low frequency timer are provided to produce a high frequency output pulse group which is terminated at different intervals by both the variable frequency divider and the timer. The characteristics of the frequency divider may be varied to produce a number of modes of generator operation, all of which utilize a single high frequency output. The generator includes apparatus for producing a voltage spike as one of the pulses of each output group with a crest ratio of at least 3:1 in the cut command group and at least 14:1 in the fulgurate mode. The spike reionizes the current path through tissue without excessive tissue destruction due to wasted power and is minimized in dessicate mode where reionization arcing is undesirable. A pair of opto-isolated hand-held switches allow the user to select continuously between two preset modes of operation without risking shock.