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 |
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 | $2137.00 | 1285912600 - THE EMORY CLINIC INC, THE EMORY CLINIC LAGRANGE SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $1143.00 | 1922365808 - GWINNETT ADVANCED SURGERY CENTER, LLC | 455067682 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $902.00 | 1366032617 - EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER, LLC | 843673604 - (MA) EMERSON ENDOSCOPY AND DIGESTIVE HEALTH CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $394.00 | 1588876817 - FREEWAY SURGERY CENTER LLC | 208957938 - (AR) FREEWAY SURGERY CENTER LLC | AR | 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 | $649.00 | 1164771762 - MARYLAND SPECIALTY SURGERY CENTER, LLC | 454793230 - (MD) MARYLAND SPECIALTY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $708.00 | 1205364981 - MERCED AMBULATORY SURGERY CENTER, LLC, UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $2137.00 | 1568884104 - EMORY AMBULATORY SURGERY CENTER AT DUNWOODY, LLC | 464115055 - (GA) EMORY AMBULATORY SURGERY CENTER AT DUNWOODY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $953.00 | 1194935577 - MILLENNIUM SURGICAL CENTER LLC | 205225327 - (NJ) MILLENNIUM SURGICAL CENTER, LLC | NJ | 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 | $530.00 | 1306973235 - DIGESTIVE DISEASE & ENDOSCOPY CENTER, LLC, DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | 912065379 - (WA) DIGESTIVE DISEASE & ENDOSCOPY CENTER, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $330.00 | 1447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER | 341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $319.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $542.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61000 | $379.00 | 1467788729 - WATERFORD SURGICAL CENTER, LLC | 271110813 - (MI) WATERFORD SURGICAL CENTER | MI | 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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