CPT 61345 Fee Schedule
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.
| 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 • AG - Primary physician |
| Complexity Level | High |
National average reimbursement for CPT 61345 by major payers:
$2,555.50
$2,779.23
$2,830.25
$3,346.00
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 61345 | ||||||
United | 61345 | $375.00 | 1578088787 - VACCO LLC | 821221738 - (OH) VACCO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $555.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $590.00 | 1568981975 - WEST MICHIGAN SURGICAL CENTER, LLC | 820593284 - (MI) WEST MICHIGAN SURGICAL CENTER, L | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $2732.00 | 1477140796 - PORTSMOUTH SURGICENTER, LLC | 833659705 - (NH) PORTSMOUTH SURGICENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $1049.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $530.00 | 1164469086 - SAME DAY SURGICARE OF NEW ENGLAND, INC., SAME DAY SURGICLINIC | 42808359 - (MA) SAME DAY SURGICARE OF NEW ENGLAND, INC. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $1274.00 | 1891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER | 562311366 - (AZ) PHOENIX SPINE GOODYEAR, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $822.00 | 1730121401 - SALEM ENDOSCOPY CENTER, LLC | 202447516 - (OR) SALEM ENDOSCOPY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $550.00 | 1841605318 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER, LLC, FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER-CITRUS PARK | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $600.00 | 1053039883 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $719.00 | 1184664609 - ENDOSCOPY CENTER AT ROBINWOOD, LLC | 20615867 - (MD) ENDOSCOPY CENTER AT ROBINWOOD LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $2882.41 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $670.00 | 1730409400 - EYE BONE, LLC, CHARDON SURGERY CENTER | 204691851 - (OH) EYE BONE, LLC DBA CHARDON SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $843.00 | 1770114290 - NORTH SUBURBAN PAIN AND SPINE CENTER LLC | 824454412 - (IL) NORTH SUBURBAN PAIN & SPINE CENT | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61345 | $175.00 | 1164930731 - REMBRANDT OUTPATIENT SURGERY CENTER PLLC, REMBRANDT OUTPATIENT SURGERY CENTER | 822368976 - (AZ) REMBRANDT OUTPATIENT SURGERY CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 61345 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61345 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 61345 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 |
|---|---|---|
| 61210-CPT | Moderate | Burr Hole(S); For Implanting Ventricular Catheter, Reservoir, Eeg Electrode(S), Pressure Recording Device, Or Other Cerebral Monitoring Device (Separate Procedure) |
| 61250-CPT | High | Trephine W Explor Supratentor Unil |
| 61323-CPT | High | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61345. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61345 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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