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See a sample rate comparisonCPT 61154 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Burr Hole(S) W/ Evacuat &/Or Drain Of Hematom Extradural O, Burr Hole(S) With Evacuation And/Or Drainage Of Hematoma Extradural O
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61154 |
| Medicaid Fee Schedule | View Medicaid rates for 61154 |
National average reimbursement for CPT 61154 by major payers:
$1,721.08
$1,719.17
$1,800.16
$2,043.79
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CPT 61154
5 of 25 sample ratesHigher to lower in this preview
Arlington Surgery Center, LLC, Arlington Surgery Center Associates, Lp
Arlington Surgery Center LLC
$6,068.00Published rateDialysis Access Center A Medical Corporation
$900.00Published rateIec Surgical Centers LLC, Physicians Surgery Center
Iec Surgical Centers LLC
$600.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Center
Southwestern Eye Center, Ltd.
$492.00Published rateZion Ambulatory Center LLC
$48.00Published rate
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See a sample payer proposalCPT 61154 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61154 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 61154 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 |
|---|---|---|
| 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. |
| 61151-CPT | High | Burr Hole(S) Or Trephine; W/ Subsequ Tapping (Aspirat) Of Intr, Burr Hole(S) Or Trephine; With Subsequent Tapping (Aspiration) Of Intr |
| 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 |
| 61156-CPT | High | Burr Holes;Aspir.Hematma/Cyst,Intra |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61154. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61154 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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