CPT 61070 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
National average reimbursement for CPT 61070 by major payers:
$96.76
$90.81
$95.86
$106.28
| 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 61070 | ||||||
United | 61070 | $2093.00 | 1063757227 - PARKVIEW ORTHO CENTER, LLC | 611697669 - (IN) PARKVIEW ORTHO CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $451.00 | 1184782203 - EASTERN OREGON REGIONAL SURGERY | 710881667 - (OR) EASTERN OREGON REGIONAL SURGERY | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $1042.00 | 1801944343 - HUDSON VALLEY AMBULATORY SURGERY, LLC | 510451539 - (NY) HUDSON VALLEY AMBULATORY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $750.00 | 1487014361 - GRIFFIN CENTER FOR PAIN AND SPINE | 473061907 - (GA) GRIFFIN CENTER FOR PAIN AND SPINE | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $745.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $374.00 | 1609996149 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $410.00 | 1023567260 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $352.00 | 1053575852 - EYNON SURGERY CENTER, LLC | 262791252 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $344.00 | 1548374267 - DALLAS SURGI CENTER, INC. | 752199927 - (TX) DALLAS SURGI CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $473.00 | 1588332712 - HAND ASC LLC | 872342845 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $377.00 | 1609848472 - PENNSYLVANIA EYE & EAR SURGERY, PA EYE & EAR SURGERY CENTER, LLC | 300145589 - (PA) PENNSYLVANIA EYE EAR SURGERY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $450.00 | 1548870603 - DURANGO SURGERY CENTER LLC, ANIMAS SURGICAL CENTER AT ESCALANTE | 851267666 - (CO) DURANGO SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $344.00 | 1932212511 - PALESTINE LASER & SURGERY CENTER PLLC | 470900270 - (TX) PALESTINE LASER SURGERY CENTER PLLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $296.00 | 1063584415 - CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA, CAROLINA DIGESTIVE ENDOSCOPY CENTER | 561335864 - (NC) CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61070 | $550.00 | 1871119107 - REGIONAL PLASTIC SURGERY CENTER PA, REGIONAL PLASTIC SURGERY CENTER - SHERMAN | 752365055 - (TX) REGIONAL PLASTIC SURGERY ASSOCIATES, P.A. | TX | 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 61070 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61070 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 61070 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 |
|---|---|---|
| 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 |
| 61070-CPT | Low | Punc Shunt Tube/Reservoir-Aspir/Inj |
| 61156-CPT | High | Burr Holes;Aspir.Hematma/Cyst,Intra |
| 61312-CPT | High | Craniectomy/Otomy-Hematoma,Supra;Extra-/ |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61070. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61070 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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