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See a sample rate comparisonCPT 61316 Fee Schedule
Last Verified: October 2026
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.
Implt Cran Bone Flap To Abdo, Incision And Subcutaneous Placement Of Cranial Bone Graft (List Separately In Addition To Code For Primary Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 61316 |
| Medicaid Fee Schedule | View Medicaid rates for 61316 |
National average reimbursement for CPT 61316 by major payers:
$143.16
$121.49
$122.29
$140.43
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CPT 61316
5 of 25 sample ratesHigher to lower in this preview
Burlington County Endoscopy Center LLC
$4,300.00Published rateOakhurst Endoscopy Asc LLC, Ocean Surgical Pavilion, Inc.
$1,344.00Published rateNorth Bend Medical Center Inc, Nbmc-Day Surgery
$865.00Published rateTattnall Hospital Company, LLC, Optim Surgery Center
$472.00Published rateSalvatore Dimercurio Md PA
Salvatore Dimercurio, M.D., P.A.
$100.00Published rate
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See a sample payer proposalCPT 61316 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61316 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 61316 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 |
|---|---|---|
| 61316-CPT | Low | Implt Cran Bone Flap To Abdo, Incision And Subcutaneous Placement Of Cranial Bone Graft (List Separately In Addition To Code For Primary Procedure) |
| 61320-CPT | High | Craniectomy Or Craniotomy Dra, Craniectomy Or Craniotomy Drainage Of Intracranial Abscesssupratentorial Craniectomy Or Craniotomy Drainage Of Intracranial Abscess |
| 61512-CPT | High | Surgery To Remove Brain Tumor, Surgery To Remove Abnormal Tissue (Tumor) From The Brain. A Portion Of The Skull Bone Is Removed For The Surgery. |
| 61518-CPT | High | Craniectomy For Excision Of Br, Craniectomy For Excision Of Brain Tumor Infratentorial Orposterior Fossa Except Meningioma Cerebellopontine Angle Tumor Or Midline Tumor At Base Of Skull |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61316 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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