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See a sample rate comparisonCPT 61020 Fee Schedule
Last Verified: October 2026
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.
Create Opening In Skull, A Procedure To Create An Opening Into The Skull Through A Previous Opening Or Implanted Tube (Catheter). The Procedure May Involve Injection Of Medication Through The Opening.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 78 - Return to OR - related procedure Q1 - Routine clinical service provided in a clinical research study |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 61020 |
| Medicaid Fee Schedule | View Medicaid rates for 61020 |
National average reimbursement for CPT 61020 by major payers:
$158.17
$154.93
$156.84
$179.53
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CPT 61020
5 of 25 sample ratesHigher to lower in this preview
Ssm St Clare Surgical Center LLC, Ssm St Clare Surgical Center
Ssm St Clare Surgical Center LLC
$1,919.00Published rateIronbound Endo Surgical Center, Inc.
$745.00Published rateDanville Polyclinic, Ltd, Danville Polyclinic Ltd Astc
Danville Polyclinic, Ltd.
$466.00Published rateMiami Asc Lp, The Endoscopy Center
Miami Asc Lp
$382.00Published ratePeninsula Eye Center, P.A, Peninsula Cataract & Laser Center
Peninsula Eye Center PA
$169.00Published rate
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See a sample payer proposalCPT 61020 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61020 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 61020 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 | Subdural Tap Through Fntanelle Or Suture Infant Unilat Or Bila, Subdural Tap Through Fontanelle Or Suture Infant Unilateral Or Bila |
| 61001-CPT | Low | Subdural Tap Through Fntanelle Or Suture Infant Unilat Or Bila, Subdural Tap Through Fontanelle Or Suture Infant Unilateral Or Bila |
| 61020-CPT | Low | Create Opening In Skull, A Procedure To Create An Opening Into The Skull Through A Previous Opening Or Implanted Tube (Catheter). The Procedure May Involve Injection Of Medication Through The Opening. |
| 61026-CPT | Low | Injection Into Brain Canal, 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 61020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61020 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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