CPT 15630 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15630 |
National average reimbursement for CPT 15630 by major payers:
$562.89
$580.02
$609.76
$744.03
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15630 | ||||||
United | 15630 | $500.00 | 1275642480 - EGNM LLC, LEWES SURGERY CENTER | 510411737 - (DE) EGNM, LLC DBA LEWES SURGERY CENTER | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $2716.00 | 1174588099 - IU HEALTH ARNETT HOSPITAL, INC, ARNETT SURGERY CENTER, LLC | 263162145 - (IN) INDIANA UNIVERSITY HEALTH ARNETT INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $1276.00 | 1992706899 - SURGERY CENTER OF PEORIA, LLC, SURGERY CENTER OF PEORIA | 731538768 - (AZ) SURGERY CENTER OF PEORIA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $2817.00 | 1396175246 - MEMORIAL HERMANN BAY AREA ENDOSCOPY CENTER, LLC, BAY AREA ENDOSCOPY | 364773048 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $1233.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $560.00 | 1497851893 - CHINIKO LLC, EYE SURGERY CENTER | 931234805 - (OR) CHINIKO LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $1526.00 | 1942722798 - DREXEL TOWN SQUARE SURGERY CENTER, LLC, DREXEL TOWN SQUARE SURGERY CENTER | 814904300 - (WI) DREXEL TOWN SQUARE SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $941.00 | 1891186987 - FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER,LLC | 464426708 - (CO) FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTERLLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $654.00 | 1124099635 - HUNTINGTON SURGERY CENTER LIMITED PARTNERSHIP, CABELL HUNTINGTON SURGERY CENTER | 550647724 - (WV) CABELL HUNTINGTON SURGERY CENTER | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $690.00 | 1326374844 - CREEKSIDE SURGERY SUITE | 680319558 - (CA) SHAHRIAR MABOURAKH, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $1846.00 | 1619333010 - ORANGE ASC, LTD, ORTHOPEDIC ONE SURGERY CENTER AT EASTON | 464700223 - (OH) ORANGE ASC LTD DBA ORTHOPEDIC ONE SURGERY CENTER AT EASTON | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $2392.00 | 1235752643 - TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH, LLC | 843814490 - (TX) TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $350.00 | 1265494553 - CORAL VIEW SURGERY CENTER, LLC | 650708055 - (FL) CORAL VIEW SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $375.00 | 1164697009 - BOX HILL SURGERY CENTER LLC | 262454678 - (MD) BOX HILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15630 | $1864.00 | 1497068761 - CARNEGIE HILL ENDOSCOPY LLC | 270385539 - (NY) CARNEGIE HILL ENDOSCOPY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15630 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15630 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 15630 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 15570-CPT | High | Form Direct Tube Pedicle W/Wo Trnsfer Tr |
| 15574-CPT | High | Formation Of Direct Or Tubed Pedicle, With Or Without Transfer; Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands Or Feet |
| 15600-CPT | Moderate | Intermediate ''delay'' Of Any Flap, Primary ''delay'' Of Small Flap, Or Sectioning Pedicle Of Tubed Or Direct Flap |
| 15630-CPT | Moderate | Intermediate ''delay'' Of Any Flap, Primary ''delay'' Of Small Flap, Or Sectioning Pedicle Of Tubed Or Direct Flap |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15630 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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