CPT 61526 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 • 62 - Co-Surgeons • 22 - Increased Procedural Services |
| Complexity Level | High |
National average reimbursement for CPT 61526 by major payers:
$4,423.88
$4,704.01
$4,863.55
$5,655.15
| 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 61526 | ||||||
United | 61526 | $1049.00 | 1316508252 - MINIMALLY INVASIVE SURGICENTER LLC | 842130499 - (FL) MINIMALLY INVASIVE SURGICENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $1049.00 | 1194724690 - ENDOSCOPY CENTER OF DAYTON NORTH LLC | 311703317 - (OH) ENDOSCOPY CENTER OF DAYTON NORTH LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $2500.00 | 1366647968 - NORTH POINTE SURGERY CENTER, LP | 204435545 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $420.00 | 1952917445 - AURORA SURGICAL CENTER LLC | 852607513 - (AZ) AURORA SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $610.00 | 1770223901 - PSA AMBULATORY SURGICAL CENTER OF SOUTH AUSTIN, LLC | 874341110 - (TX) PSA AMBULATORY SURGICAL CENTER OF SOUTH AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $125.00 | 1144219908 - HSC SURGICAL ASSOCIATES OF CINCINNATI, LLC, TRI STATE ENDOSCOPY CENTER | 311386408 - (OH) HSC SURGICAL ASSOCIATES OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $968.00 | 1669496345 - MNGI ENDOSCOPY ASC INC | 205174032 - (MN) MNGI ENDOSCOPY ASC INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $1064.00 | 1891148219 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $850.00 | 1962668319 - BOULDER MEDICAL CENTER, PC, BOULDER MEDICAL CENTER ASC | 840834835 - BOULDER MEDICAL CENTER, P.C. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $106.00 | 1447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER | 341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $383.00 | 1629262811 - PREMIER ENDOSCOPY CENTER LLC | 205055187 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $625.00 | 1093389421 - PEACHTREE ORTHOPAEDIC SURGERY CENTER-NORTH, LLC | 862640910 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTERNORTH LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $732.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $559.00 | 1619487782 - UCH VASCULAR ACCESS ASC LLC | 820975009 - (TN) UCH VASCULAR ACCESS ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61526 | $592.00 | 1447223938 - CHATTANOOGA ENDOSCOPY ASC LLC, CHATTANOOGA ENDOSCOPY CENTER | 621789882 - (TN) CHATTANOOGA ENDOSCOPY, ASC, LLC | TN | 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 61526 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61526 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 61526 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 |
| 61531-CPT | High | Subdural Implantation Of Strip Electrodes Through One Or More Burr Or Trephine Hole(S) For Long Term Seizure Monitori |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61526. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61526 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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