Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 61250 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) Or Trephine Supratentorial Explorat Not Follow By, Burr Hole(S) Or Trephine Supratentorial Exploratory Not Followed By
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61250 |
| Medicaid Fee Schedule | View Medicaid rates for 61250 |
National average reimbursement for CPT 61250 by major payers:
$1,204.36
$1,166.25
$1,184.34
$1,387.63
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 61250.
CPT 61250
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Dallas
$11,727.00Published rateBsc 3 LLC, Banner Surgery Center - Sports Medicine
Bsc 3 LLC
$1,124.00Published rateThe Endoscopy Center At Bainbridge LLC
$853.00Published rateFlowood Surgery Center LLC
$550.00Published rateNortheast Ambulatory Center Inc
Northeast Ambulatory Center, Inc.
$122.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 61250 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61250 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 61250 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 | Create Opening In Skull, A Procedure To Create An Opening Into The Skull Through A Previous Opening Or Implanted Tube (Catheter). The Procedure May Involve Injection Of Medication Through The Opening. |
| 61026-CPT | Low | Injection Into Brain Canal, Ventricular Puncture Through Previous Burr Hole Fontanelle Suture Or Implanted Ventricular Catheter Reservoir With Injection Of Medication Or Other Substance For Diagnosis Or Treatment |
| 61105-CPT | Moderate | Puncture Ventric W Twist Drill |
| 61250-CPT | High | Burr Hole(S) Or Trephine Supratentorial Explorat Not Follow By, Burr Hole(S) Or Trephine Supratentorial Exploratory Not Followed By |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61250 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61250) and we'll show you how you compare in 15 minutes or less.