CPT 61520 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 • 11 - Office |
| Common Modifiers | • None • 62 - Co-Surgeons • 22 - Increased Procedural Services |
| Complexity Level | High |
National average reimbursement for CPT 61520 by major payers:
$4,785.45
$5,144.28
$5,348.03
$6,148.44
| 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 61520 | ||||||
United | 61520 | $2377.00 | 1083384432 - NASHVILLE SURGICENTER, LLC | 474086590 - (TN) NASHVILLE SURGICENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $1274.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $288.00 | 1396771036 - THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | 30426509 - (VA) THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $1101.00 | 1164582649 - STRICTLY PEDIATRICS SURGERY CENTER OF CENTRAL TEXAS, LLC, STRICTLY PEDIATRICS SURGERY CENTER | 200943974 - (TX) STRICTLY PEDIATRICS SURGERY CENTER OF TEXAS, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $461.00 | 1164478764 - SURGERY CENTER OF LAWTON PROFESSIONAL LLC | 731579076 - (OK) SURGERY CENTER OF LAWTON PROFESSIONAL LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $340.00 | 1245201425 - ANDRE J GOLINO MD AND ASSOCIATES PA, PALM BEACH EYE CLINIC | 592348880 - (FL) ANDRE J GOLINO MD AND ASSOCIATES PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $415.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 871193981 - (FL) TGH SURGERY CENTER AT MORSANI LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $625.00 | 1093146771 - NORTHWEST COMMUNITY DAY SURGERY CENTER II LLC | 300798249 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $7604.00 | 1235195033 - NORTH COAST SURGERY CENTER LTD | 752448928 - (CA) NORTH COAST SURGERY CENTER LTD | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $1032.00 | 1750491205 - ENT SURGERY CENTER OF ATLANTA,LLC | 200075229 - (GA) ENT SURGERY CENTER OF ATLANTALLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $829.00 | 1538736459 - PONY CREEK ANNEX, LLC | 844833158 - (OR) PONY CREEK ANNEX LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $250.00 | 1891406328 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $850.00 | 1962668319 - BOULDER MEDICAL CENTER, PC, BOULDER MEDICAL CENTER ASC | 840834835 - BOULDER MEDICAL CENTER, P.C. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $603.00 | 1437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER | 470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61520 | $1274.00 | 1528077658 - PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC, PRINCE WILLIAM SURGERY CENTER | 770594498 - (VA) PRINCE WILLIAM AMBULATORY | VA | 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 61520 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61520 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 61520 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 |
|---|---|---|
| 61520-CPT | High | Exc Tumor Cerebellopontine Angle |
| 61526-CPT | High | Exc Les Cerebellopont Transtemp |
| 61530-CPT | High | Craniectomy, Bone Flap Craniotomy, Transtemporal (Mastoid) For Excision Of Cerebellopontine Angle Tumor; Combined With Middle/Posterior Fossa Craniotomy/Craniectomy |
| 61534-CPT | High | Craniectomy, Trephination, Bone Flap Craniotomy; For Excision Of Epileptogenic Focus Without Electrocortico |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61520 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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