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See a sample rate comparisonCPT 61304 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.
Craniectomy Or Craniotomy Exp, Craniectomy Or Craniotomy Exploratory Supratentorialcraniectomy Or Craniotomy Exploratory Supratentorial
| 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 AS - PA/NP/CNS assistant at surgery 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61304 |
| Medicaid Fee Schedule | View Medicaid rates for 61304 |
National average reimbursement for CPT 61304 by major payers:
$2,048.53
$2,244.14
$2,369.84
$2,637.29
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CPT 61304
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Azle
$9,124.00Published rateSpine Solutions Of Sheboygan LLC
$916.00Published rateAcd-Sa, Ltd., Sendero Imaging And Treatment Center
$575.00Published rateTaylor Surgery Center, LLC, Surgical Arts Surgery Center
Taylor Surgery Center LLC
$457.00Published rateEast Texas Eye Associates, East Texas Eye Associates Surgery Center
$95.00Published rate
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See a sample payer proposalCPT 61304 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61304 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 61304 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 |
|---|---|---|
| 61304-CPT | High | Craniectomy Or Craniotomy Exp, Craniectomy Or Craniotomy Exploratory Supratentorialcraniectomy Or Craniotomy Exploratory Supratentorial |
| 61305-CPT | High | Crniectomy Or Crniotomy Explorat; Nfrtentorial (Posteri Foss, Craniectomy Or Craniotomy Exploratory; Infratentorial (Posterior Foss |
| 61312-CPT | High | Rnec/Crnot Sttl Xdrl/Sdrl, Removal Of Skull Bone For Aspiration Of Blood Accumulation In Upper Brain Outside Or Below Brain Membrane |
| 61314-CPT | High | Rnec/Crnot Ittl Xdrl/Sdrl, Removal Of Skull Bone For Aspiration Of Blood Accumulation In Lower Brain Outside Or Below Brain Membrane |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61304 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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