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See a sample rate comparisonCPT 61305 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.
Crniectomy Or Crniotomy Explorat; Nfrtentorial (Posteri Foss, Craniectomy Or Craniotomy Exploratory; Infratentorial (Posterior Foss
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 78 - Return to OR - related procedure GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61305 |
| Medicaid Fee Schedule | View Medicaid rates for 61305 |
National average reimbursement for CPT 61305 by major payers:
$2,530.08
$2,732.80
$2,771.99
$3,209.45
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CPT 61305
5 of 25 sample ratesHigher to lower in this preview
Union Health Services, LLC, Atrium Health Surgery Center Indian Trail
Union Health Services LLC
$6,500.00Published rateHunterdon Endosurgery Center
$1,352.00Published rateAdventist Healthcare Sc At National Harbor, LLC
Adventist Healthcare Sc At National Harbor LLC
$775.00Published ratePain Treatment Centers Of Michigan LLC, Matrix Surgery Center
Pain Treatment Centers Of Michigan LLC
$524.00Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$110.00Published rate
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See a sample payer proposalCPT 61305 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61305 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 61305 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 |
|---|---|---|
| 61210-CPT | Moderate | Pierce Skull Implant Device, Burr Hole S For Implanting Ventricular Catheter Reservoir Eeg Electrode S Pressure Recording Device Or Other Cerebral Monitoring Device Separate Procedure |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61305 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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