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See a sample rate comparisonCPT 61321 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 Dra, Craniectomy Or Craniotomy Drainage Of Intracranial Abscessinfratentorial Craniectomy Or Craniotomy Drainage Of Intracranial Abscess
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 78 - Return to OR - related procedure AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61321 |
| Medicaid Fee Schedule | View Medicaid rates for 61321 |
National average reimbursement for CPT 61321 by major payers:
$2,667.84
$2,894.22
$2,962.45
$3,388.34
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CPT 61321
5 of 25 sample ratesHigher to lower in this preview
St. Joseph'S Surgery Center Lp
St Josephs Surgery Center Lp
$2,919.00Published rateThe Surgery Center At Jensen Beach, LLC
The Surgery Center At Jensen B
$1,064.00Published rateTexoma Valley Surgery Center Lp
$550.00Published rateRidgecrest Specialty Surgery Center, A Professional Corporation
Ridgecrest Specialty Surgery Center A Professional Corporation
$459.00Published rateNorth Valley Endoscopy Center LLC
$109.00Published rate
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See a sample payer proposalCPT 61321 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61321 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 61321 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 |
|---|---|---|
| 61070-CPT | Low | Puncture Of Shunt Tubing Or R, Puncture Of Shunt Tubing Or Reservoir For Aspiration Orinjection Procedure Puncture Of Shunt Tubing Or Reservoir For Aspiration Or |
| 61108-CPT | High | Tdh Pnxr Evac&/Drg Sdrl Hmta, Twist Drill Hole(S) For Subdural Intracerebral Or Ventricular Puncture; For Evacuation And/Or Drainage Of Subdural Hematoma |
| 61321-CPT | High | Craniectomy Or Craniotomy Dra, Craniectomy Or Craniotomy Drainage Of Intracranial Abscessinfratentorial Craniectomy Or Craniotomy Drainage Of Intracranial Abscess |
| 61514-CPT | High | Remove Infection From Brain, Surgery In Which A Portion Of The Skull Is Removed And An Abscess (Pocket Of Infection) Is Removed From The Brain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61321 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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