CPT 61530 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 |
| Medicare Fee Schedule | View Medicare rates for 61530 |
National average reimbursement for CPT 61530 by major payers:
$3,677.55
$4,174.76
$4,205.65
$5,012.82
| 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 61530 | ||||||
United | 61530 | $1274.00 | 1871751859 - WESTMINSTER SURGERY CENTER | 262059600 - (MD) WESTMINSTER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $438.00 | 1366496143 - VIRGINIA SURGERY CENTER, LLC, CVP SURGERY CENTER | 541922041 - (VA) VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1124.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $370.00 | 1265538151 - SUFFOLK SURGERY CENTER LLC | 200080609 - (NY) SUFFOLK SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $380.00 | 1164476933 - NOVAMED SURGERY CENTER OF SAN ANTONIO LP, AMERICAN SURGERY CENTER | 204400460 - (TX) NOVAMED SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1228.00 | 1811940141 - SOUTHPARK SURGERY CENTER LLC, SOUTHPARK SURGERY CENTER | 870714098 - (NC) SOUTHPARK SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $534.00 | 1487609335 - THE CENTER FOR AESTHETIC SURGERY LLC | 200431536 - (MD) THE CENTER FOR AESTHETIC SURGERY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $2172.00 | 1336459353 - LONE STAR ENDOSCOPY CENTER LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $475.00 | 1275802183 - PRECISION VISION SURGERY CENTER, LLC | 731097247 - (OK) EDWARD D. GLINSKI, D.O. & ACCOCIATES, INC. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1504.00 | 1386190957 - HOLLY SPRINGS SURGERY CENTER, LLC | 473460976 - (NC) HOLLY SPRINGS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1049.00 | 1235178146 - SUBURBAN ENDOSCOPY CENTER, LLC, SUBURBAN ENDOSCOPY CENTER | 820556996 - (NJ) SUBURBAN ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1167.00 | 1154474583 - CREEKWOOD SURGERY CENTER, LP | 431656044 - (MO) CREEKWOOD SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $706.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1215.00 | 1487610390 - SURGERY CENTER OF FAIRFIELD COUNTY LLC, HEALTHSOUTH SURGERY CENTER OF BRIDGEPORT, LLC | 201733152 - (CT) SURGERY CENTER OF FAIRFIELD COUNTY LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1064.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | 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 61530 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61530 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 61530 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 |
| 61521-CPT | High | Craniectomy-Excis.Brain Tumor/Fossa;Midl |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61530. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61530 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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