CPT 61000 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 Nervous System |
| Common Place of Service | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 78 - Return to OR - related procedure |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 61000 |
National average reimbursement for CPT 61000 by major payers:
$152.00
$152.10
$156.22
$184.66
| 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 61000 | ||||||
United | 61000 | $379.00 | 1811950298 - SOUTH HILL AMBULATORY SURGICAL CENTER PS | 911546856 - (WA) SOUTH HILL AMBULATORY SURGICAL CENTER PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $315.00 | 1831109875 - M-S SURGERY CENTER LLC | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $552.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $978.00 | 1457682841 - PAIN CARE OF NORTH TEXAS | 200081985 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $1490.00 | 1053585125 - BJOSC, LLC, BONE & JOINT SURGERY CENTER | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $449.00 | 1932496908 - CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC, CONCOURSE DIAGNOSTIC SURGERY CENTER,LLC | 273205326 - (CA) CONCOURSE DIAGNOSTIC & SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $194.00 | 1023039195 - CAPE SURGERY CENTER, LLC | 200649544 - (TN) CAPE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $580.00 | 1528572815 - SUN SURGERY CENTER HUNTINGTON LLC | 822382700 - (CA) SUN SURGERY CENTER HUNTINGTON LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $264.00 | 1821093204 - LAUREL LASER & SURGERY CENTER, L.P. | 251852464 - (PA) LAUREL LASER SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $312.00 | 1679757959 - THOMAS JOHNSON SURGERY CENTER, LLC | 261579919 - (MD) THOMAS JOHNSON SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $967.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $1158.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $800.00 | 1053328781 - LOS ALAMITOS SURGERY CENTER L P | 550823348 - (CA) LOS ALAMITOS SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $509.00 | 1982853271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, SUNRISE ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $800.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | 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 61000 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61000 code is part of the Surgery services used for Surgical Procedures on the Nervous 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 61000 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 |
|---|---|---|
| 61000-CPT | Low | Tap Subdural Infant Initial |
| 61001-CPT | Low | Subdural Tap Thru Fontanelle,Infant;U/Bi |
| 61020-CPT | Low | Ventricular Puncture Through Previous Burr Hole, Fontanelle, Suture, Or Implanted Ventricular Catheter/Reservoir; Without Injection |
| 61026-CPT | Low | Ventricular Puncture Through Previous Burr Hole, Fontanelle, Suture, Or Implanted Ventricular Catheter/Reservoir; With Injection Of Medication Or Other Substance For Diagnosis Or Treatment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61000 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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