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See a sample rate comparisonCPT 61315 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 For Evacuat Of Hematom Nfrtentorial;, Craniectomy Or Craniotomy For Evacuation Of Hematoma Infratentorial;
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room 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 61315 |
| Medicaid Fee Schedule | View Medicaid rates for 61315 |
National average reimbursement for CPT 61315 by major payers:
$2,699.88
$2,824.15
$2,961.16
$3,312.79
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CPT 61315
5 of 25 sample ratesHigher to lower in this preview
Mid-America Surgery Institute LLC
Midamerica Surgery Institute LLC
$2,732.00Published rateFlorida Orthopaedic Institute Surgery Center LLC
$1,274.00Published rateFresno Specialty Surgery Center PC
$565.00Published rateSuffolk Surgery Center LLC
$370.00Published rateCareplex Orthopaedic Ambulatory Surgery Center, LLC, None
Careplex Orthopaedic Ambulatory Surgery Center LLC
$259.00Published rate
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See a sample payer proposalCPT 61315 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61315 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 61315 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 |
|---|---|---|
| 61313-CPT | High | Crniectomy Or Crniotomy For Evacuat Of Hematom Supratentorial;, Craniectomy Or Craniotomy For Evacuation Of Hematoma Supratentorial; |
| 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 |
| 61315-CPT | High | Crniectomy Or Crniotomy For Evacuat Of Hematom Nfrtentorial;, Craniectomy Or Craniotomy For Evacuation Of Hematoma Infratentorial; |
| 61330-CPT | High | Relieve Pressure On Eye Socket, Surgery To Relieve Pressure On The Orbit (Bony Socket That Houses The Eyeball) Due To Fracture (Break). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61315 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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