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See a sample rate comparisonCPT 61343 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.
Incise Skull Press Relief, Craniectomy Suboccipital With Cervical Laminectomy For Decompression Of Medulla And Spinal Cord With Or Without Dural Graft Eg Arnold Chiari Malformation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61343 |
| Medicaid Fee Schedule | View Medicaid rates for 61343 |
National average reimbursement for CPT 61343 by major payers:
$2,866.71
$3,005.09
$3,262.16
$3,523.15
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CPT 61343
5 of 25 sample ratesHigher to lower in this preview
Lexington Health Inc, Lmc Irmo Asc
Lexington Health Inc
$3,557.00Published rateGwinnett Surgery Center, LLC
Gwinnett Surgery Center,LLC
$1,630.00Published rateCase Center For Surgery & Endoscopy LLC
Case, LLC
$650.00Published rateTri-Cities Endoscopy Center PC, The Center For Digestive Wellness
Tricities Endoscopy Center PC
$350.00Published rateSkin & Mohs Surgery Center, LLC
Skin Mohs Surgery Center LLC
$194.00Published rate
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See a sample payer proposalCPT 61343 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61343 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 61343 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 |
|---|---|---|
| 61050-CPT | Low | Cisternal Or Lateral Cervcal (C1-C2) Punctur; W/O Inject (Sep, Cisternal Or Lateral Cervical (C1-C2) Puncture; Without Injection (Sep |
| 61343-CPT | High | Incise Skull Press Relief, Craniectomy Suboccipital With Cervical Laminectomy For Decompression Of Medulla And Spinal Cord With Or Without Dural Graft Eg Arnold Chiari Malformation |
| 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. |
| 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 61343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61343 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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