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See a sample rate comparisonCPT 61323 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.
Decompressive Lobectomy, Craniectomy Or Craniotomy Decompressive With Or Without Duraplasty For Treatment Of Intracranial Hypertension Without Evacuation Of Associated Intraparenchymal Hematoma With Lobectomy
| 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 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61323 |
| Medicaid Fee Schedule | View Medicaid rates for 61323 |
National average reimbursement for CPT 61323 by major payers:
$3,308.61
$3,241.84
$3,319.86
$3,795.16
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CPT 61323
5 of 25 sample ratesHigher to lower in this preview
Carris Health LLC, Centracare Willmar Surgery Center
Carris Health LLC
$3,418.00Published rateDmg Pain Management Surgery Center, LLC
Dmg Pain Management Surgery Center LLC
$1,137.00Published rateSummit Ambulatory Surgical Center, LLC
$1,028.00Published rateNorth Georgia Endoscopy Center Inc
$500.00Published rateAkdhc Surgery Center, LLC
$100.00Published rate
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See a sample payer proposalCPT 61323 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61323 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 61323 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 |
|---|---|---|
| 61250-CPT | High | Burr Hole(S) Or Trephine Supratentorial Explorat Not Follow By, Burr Hole(S) Or Trephine Supratentorial Exploratory Not Followed By |
| 61323-CPT | High | Decompressive Lobectomy, Craniectomy Or Craniotomy Decompressive With Or Without Duraplasty For Treatment Of Intracranial Hypertension Without Evacuation Of Associated Intraparenchymal Hematoma With Lobectomy |
| 61345-CPT | High | Other Cranial Decompression, Posterior F |
| 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 61323. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61323 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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