CPT 61050 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • UA |
| Complexity Level | Low |
National average reimbursement for CPT 61050 by major payers:
$129.46
$125.94
$118.97
$146.88
| 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 61050 | ||||||
United | 61050 | $3624.00 | 1730227992 - MEMORIAL AMBULATORY SURGERY CENTER, LLC | 210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $566.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $836.00 | 1720543481 - SURGICAL SUITES OF COASTAL VIRGINIA, LLC | 833205375 - (VA) SURGICAL SUITES OF COASTAL VIRGINIA LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $907.00 | 1083873277 - VENTURE AMBULATORY SURGERY CENTER LLC | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $248.00 | 1831109560 - NEW MEXICO ORTHOPAEDIC SURGERY CENTER, LLC, NEW MEXICO SURGERY CENTER ORTHOPAEDICS | 621797896 | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $253.00 | 1003144353 - PIEDMONT WEST AMBULATORY SURGERY CENTER | 264422348 - (GA) PIEDMONT WEST AMBULATORY SURGERY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $600.00 | 1659810703 - MILWAUKEE SURGICAL SUITES, LLC | 814264488 - (WI) MILWAUKEE SURGICAL SUITES, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $688.00 | 1518356070 - DIGESTIVE DISEASE CENTER OF AMARILLO LLC | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $135.00 | 1588879266 - BAYSIDE ENDOSCOPY CENTER LLC, EAST GREENWICH ENDOSCOPY CENTER | 200207545 - (RI) BAYSIDE ENDOSCOPY CENTER LLC | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $228.00 | 1164852455 - NURA SURGICAL CENTER LLC, MINNEAPOLIS PAIN CENTERS LLC | 901026241 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $80.00 | 1255446910 - DOWNTOWN BALTIMORE SURGERY CENTER, LLC | 522219532 - (MD) DOWNTOWN BALTIMORE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $566.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $1042.00 | 1881667368 - FLORHAM PARK ENDOSCOPY ASC LLC, FLORHAM PARK ENDOSCOPY CENTER | 621774936 - (NJ) FLORHAM PARK ENDOSCOPY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $86.00 | 1326379967 - WEIR ASC, LLC, SOUTHWEST EYE SURGERY CENTER | 271659546 - (OK) WEIR ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $100.00 | 1477500767 - SOUTHPOINT SURGERY CENTER, LLC | 203579196 - (FL) SOUTHPOINT SURGERY CENTER, LLC | FL | 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 61050 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61050 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 61050 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 |
|---|---|---|
| 61050-CPT | Low | Puncture Cisternal |
| 61055-CPT | Low | Cisternal Or Lateral Cervical (C1-C2) Puncture; With Injection Of Medication Or Other Substance For Diagnosis Or Treatment (Desc Revised 01/01/15) |
| 61154-CPT | High | Burr Holes-Evacuate/Drain Hematoma |
| 61321-CPT | High | Drainage Abscess Infratentorial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61050. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61050 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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