CPT 61210 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 • 78 - Return to OR - related procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 61210 |
National average reimbursement for CPT 61210 by major payers:
$485.78
$514.54
$546.71
$608.39
| 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 61210 | ||||||
United | 61210 | $125.00 | 1952820037 - BOWDEN GASTRO ASSOCIATES LLC | 822738390 - (TN) BOWDEN GASTRO ASSOCIATES LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $561.00 | 1497206890 - MIDWEST EYE CONSULTANTS OHIO, INC., CATARACT & LASER INSTITUTE ASC - MAUMEE #352 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $120.00 | 1447685458 - CHECKERSPOT SURGERY CENTERS, LLC | 463181931 - (MD) CHECKERSPOT SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $1049.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $1064.00 | 1972886190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $100.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $509.00 | 1508318411 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $3201.00 | 1508500273 - GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC | 262157335 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $1687.00 | 1316395270 - IRVINE SURGICAL PARTNERS LLC | 812776218 - (CA) IRVINE SURGICAL PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $700.00 | 1851356786 - WAUSAU SURGERY CENTER LLC | 621525773 - (WI) WAUSAU SURGERY CENTER, L.P. | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $983.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $604.00 | 1225245723 - FRESNO ENDOSCOPY CENTER | 770462622 - (CA) FRESNO ENDOSCOPY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $499.00 | 1851312771 - COLUMBUS ENDOSCOPY CENTER, INC | 640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $662.00 | 1588620306 - SPECIALTY ORTHOPAEDICS SURGERY CENTER | 201170147 - (GA) SPECIALTY ORTHOPAEDICS SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61210 | $384.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | 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 61210 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61210 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 61210 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 |
|---|---|---|
| 61020-CPT | Low | Ventricular Puncture Through Previous Burr Hole, Fontanelle, Suture, Or Implanted Ventricular Catheter/Reservoir; Without Injection |
| 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 |
| 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 61210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61210 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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