Suppose $M$ is a closed $n$-dimensional spin$^c$ manifold with spin$^c$ structure $σ$ and associated spin$^c$ line bundle $L$. If one fixes a Riemannian metric $g$ on $M$ and a connection $\nabla_L$ on $L$, the generalized scalar curvature $R^{\text{gen}}$ of $(M,L)$ is $R_g - 2|Ω_L|_{\text{op}}$, where $|Ω_L|_{\text{op}}$ is the pointwise operator norm of the curvature $2$-form $Ω_L$ of $\nabla_L$, acting on spinors. In a previous paper, we showed that positivity of $R^{\text{gen}}$ is obstructed by the non-vanishing of the index of the spin$^c$ Dirac operator on $(M,g,L,\nabla_L)$, and that in some cases, the vanishing of this index guarantees the existence of a pair $(g,\nabla_L)$ with positive generalized scalar curvature. Building on this and on surgery techniques inspired by those that have been developed in the theory of positive scalar curvature on spin manifolds, we show that if $\dim M = n \ge 5$, if the fundamental group $π$ of $M$ is in a large class including surface groups and finite groups with periodic cohomology, and if $M$ is totally non-spin (meaning that the universal cover is not spin), then $(M,L)$ admits positive generalized scalar curvature if and only if the generalized $α$-invariant of $(M,L)$ vanishes in the $K$-homology group $K_n(Bπ)$. We also develop an analogue of Stolz's sequence for computing the group of concordance classes of positive generalized scalar curvature metrics, and connect this to the analytic surgery sequence of Roe and Higson. Finally, we give a number of applications to moduli spaces of positive generalized scalar curvature metrics.