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See a sample rate comparisonCPT 61526 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.
Crniectomy Bone Flap Crniotomy Trnstmporal (Mastoid) For Xcisio, Craniectomy Bone Flap Craniotomy Transtemporal (Mastoid) For Excisio
| 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 |
| Medicare Fee Schedule | View Medicare rates for 61526 |
| Medicaid Fee Schedule | View Medicaid rates for 61526 |
National average reimbursement for CPT 61526 by major payers:
$4,423.88
$4,704.01
$4,863.55
$5,510.88
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CPT 61526
5 of 25 sample ratesHigher to lower in this preview
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
$10,364.00Published rateFlorida Orthopaedic Institute Surgery Center LLC
$1,274.00Published rateSummit Ambulatory Surgical Center, LLC
$1,028.00Published rateChattanooga Endoscopy Asc LLC, Chattanooga Endoscopy Center
Chattanooga Endoscopy, Asc, LLC
$592.00Published rateRf Eye PC, Cochise Eye & Laser Asc
R.F. Eye, PC
$100.00Published rate
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See a sample payer proposalCPT 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 | Craniectomy For Excision Of Br, Craniectomy For Excision Of Brain Tumor Infratentorial Orposterior Fossa Cerebellopontine Angle Tumor |
| 61526-CPT | High | Crniectomy Bone Flap Crniotomy Trnstmporal (Mastoid) For Xcisio, Craniectomy Bone Flap Craniotomy Transtemporal (Mastoid) For Excisio |
| 61530-CPT | High | Removal Of Brain Lesion, 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, Subdural Implantation Of Strip Electrodes Through One Ormore Burr Or Trephine Hole(S) For Long Term Seizure Monitoring |
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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