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 |
| Medicare Fee Schedule | View Medicare rates for 61050 |
National average reimbursement for CPT 61050 by major payers:
$129.46
$125.94
$118.97
$145.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 61050 | $907.00 | 1083873277 - VENTURE AMBULATORY SURGERY CENTER LLC | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $531.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $688.00 | 1174073506 - WILSHIRE ENDOSCOPY CENTER LLC | 813966913 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $70.00 | 1447234919 - GENGASTRO LLC, ENDOSCOPY CENTER FOR DIGESTIVE HEALTH | 562315623 - (IA) GENGASTRO LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $531.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $566.00 | 1932735677 - PARKCREEK ASC LLC | 843082809 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $531.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $150.00 | 1023153160 - INNOVIA SURGERY CENTER, LLC, ADVANTAGE HEALTHCARE | 364167589 - (IL) INNOVIA SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $82.00 | 1528206141 - HATTIESBURG EYE CLINIC CATARACT & LASIK SURGERY CENTER, LLC | 200379151 - (MS) HATTIESBURG EYE CLINIC CATARACT LASIK SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $182.00 | 1487620472 - RIVER ROAD SURGERY CENTER LLC | 931273946 - (OR) RIVER ROAD SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $128.00 | 1699256404 - LEGACY SURGERY CENTER LLC | 831722822 - (FL) LEGACY SURGERY CENTER LLC | FL | 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 | 61050 | $161.00 | 1467153718 - WATERFRONT SURGERY CENTER LLC | 881302078 - (KS) WATERFRONT SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $531.00 | 1790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP | 810587498 - (AZ) METRO SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61050 | $57.00 | 1053685677 - ARKANSAS CENTER FOR SURGICAL EXCELLENCE | 454640707 - (AR) ARKANSAS CENTER FOR SURGICAL EXCELLENCE | AR | 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 | Cisternal Or Lateral Cervcal (C1-C2) Punctur; W/O Inject (Sep, Cisternal Or Lateral Cervical (C1-C2) Puncture; Without Injection (Sep |
| 61055-CPT | Low | Injection Near Spinal Cord, Procedure To Inject Dye Or Other Substance In The Space Surrounding The Spinal Cord (Spinal Canal). The Injection Occurs Between The Backbones (Vertebra) Near The Base Of The Skull (Neck). The Procedure Is Often Performed Prior To X-Rays Of The Spinal Canal. |
| 61154-CPT | High | Burr Hole(S) W/ Evacuat &/Or Drain Of Hematom Extradural O, Burr Hole(S) With Evacuation And/Or Drainage Of Hematoma Extradural O |
| 61321-CPT | High | Craniectomy Or Craniotomy Dra, Craniectomy Or Craniotomy Drainage Of Intracranial Abscessinfratentorial Craniectomy Or Craniotomy Drainage Of Intracranial Abscess |
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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