CPT 61105 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 • 23 - Emergency Room |
| Common Modifiers | • None • AG - Primary physician • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 61105 |
National average reimbursement for CPT 61105 by major payers:
$676.21
$623.04
$650.04
$767.28
| 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 61105 | ||||||
United | 61105 | $1095.00 | 1760457204 - ORTHOPAEDIC SURGERY CENTER OF ILLINOIS, LLC | 371366377 - (IL) ORTHOPAEDIC SURGERY CENTER OF ILLINOIS LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $1114.00 | 1023551413 - MID-BRONX ENDOSCOPY CENTER LLC | 471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $1600.00 | 1598848632 - SAN MATEO SURGERY CENTER | 510655329 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $2480.00 | 1740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER | 770573567 - (CA) PLAZA SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $1104.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $1842.00 | 1720543481 - SURGICAL SUITES OF COASTAL VIRGINIA, LLC | 833205375 - (VA) SURGICAL SUITES OF COASTAL VIRGINIA LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $1000.00 | 1164019485 - WAUKESHA SURGICENTER, LLC | 854083608 - (WI) WAUKESHA SURGICENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $384.00 | 1336605351 - KURESMART PAIN MANAGEMENT SURGERY CENTER, CLEARWAY SURGERY CENTER OF DUNDALK | 832407319 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $600.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $7400.00 | 1386159853 - BELTWAY SURGERY CENTERS, LLC, EAGLE HIGHLANDS SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $950.00 | 1326309394 - ADVANCED SURGERY CENTER OF ORLANDO LLC | 453785008 - (FL) ADVANCED SURGERY CENTER OF ORLANDO LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $750.00 | 1952325227 - SLINGSBY & WRIGHT EYE SURGERY & LASER CENTER, LLC | 460461283 - (SD) SLINGSBY & WRIGHT EYE SURGERY & LASER CENTER, LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $139.00 | 1962556076 - AK SURGERY CENTER, LLC | 203332833 - (CA) AK SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $403.00 | 1558618116 - TAVARES SURGERY LLC | 300728155 - (FL) TAVARES SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61105 | $430.00 | 1326215468 - ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | 261470972 - (MI) ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | 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 61105 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61105 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 61105 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 |
|---|---|---|
| 61105-CPT | Moderate | Puncture Ventric W Twist Drill |
| 61107-CPT | Moderate | Twist Drill Hole(S) For Subdural, Intracerebral, Or Ventricular Puncture; For Implanting Ventricular Catheter, Pressure Recording Device, Or Other Intracerebral Monitoring Device |
| 61108-CPT | High | Twist Drill Hole(S) For Subdural, Intracerebral, Or Ventricular Puncture; For Evacuation And/Or Drainage Of Subdural Hematoma |
| 61210-CPT | Moderate | Burr Hole(S); For Implanting Ventricular Catheter, Reservoir, Eeg Electrode(S), Pressure Recording Device, Or Other Cerebral Monitoring Device (Separate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61105 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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