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See a sample rate comparisonCPT 39561 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Partial Diaphragm Removal, Surgery To Remove A Portion Of The Diaphragm. The Remaining Sections May Be Sewn Together Or Patched With A Muscle Graft.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Mediastinum and Diaphragm |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $1,217.80 national non-facility rate (2026) · View Medicare rates for 39561 |
| Medicaid Fee Schedule | $948.085 median of the 8 states in the free preview · View Medicaid rates for 39561 |
National average reimbursement for CPT 39561 by major payers:
$1,598.73
$1,618.11
$1,658.60
$1,996.99
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CPT 39561
5 of 25 sample ratesHigher to lower in this preview
Franconia-Springfield Surgery Center, LLC, Inova Surgery Center @ Franconia-Springfield
Inova Ambulatory Surgical Centers
$3,931.00Published rateLeigh Orthopedic Surgery Center, LLC
Leigh Orthopedic Surgery Center LLC
$1,954.00Published rateSand Lake Surgicenter LLC, Sand Lake Surgery Center
Sand Lake Surgicenter, LLC
$840.00Published rateMidwest Eye Consultants Ohio, Inc., Cataract & Laser Institute Asc - Maumee #352
Midwest Eye Consultants Ohio Inc
$561.00Published rateCalifornia Skin Surgery Center Inc
$122.00Published rate
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See a sample payer proposalCPT 39561 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39561 code is part of the Surgery services used for Surgical Procedures on the Mediastinum and Diaphragm. 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 39561 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 |
|---|---|---|
| 39503-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 39540-CPT | High | Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed. |
| 39560-CPT | Moderate | Partial Diaphragm Removal, Surgery To Remove A Portion Of The Diaphragm. The Remaining Sections May Be Sewn Together Or Patched With A Muscle Graft. |
| 39561-CPT | High | Partial Diaphragm Removal, Surgery To Remove A Portion Of The Diaphragm. The Remaining Sections May Be Sewn Together Or Patched With A Muscle Graft. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39561 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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