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 |
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 | $1028.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $6068.00 | 1770145351 - TEXAS HEALTH SPINE SURGERY CENTER ALLIANCE LLC | 320571301 - (TX) TEXAS HEALTH SPINE SURGERY CENTER ALLIANCE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1630.00 | 1871895821 - GWINNETT SURGERY CENTER, LLC | 272819709 - (GA) GWINNETT SURGERY CENTER,LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $2172.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | 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 | $461.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1899.00 | 1912097700 - NEW LEXINGTON CLINIC, PSC, ENDOSCOPY AND SURGICAL CENTER OF LEXINGTON CLINIC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $105.00 | 1285333914 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALISTS CENTER, LLC - SCOTTSDALE | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $865.00 | 1376774208 - DIGESTIVE DISEASES DIAGNOSTIC & TREATMENT CENTER LLC | 261319443 - (NY) DIGESTIVE DISEASES DIAGNOSTIC TREATMENT CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1049.00 | 1326435926 - SELECT PHYSICIANS SURGERY CENTERS | 383935220 - (FL) SELECT PHYSICIANS SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $715.00 | 1033181862 - EL PASO ASC LP, ENDOSCOPY CENTER OF EL PASO | 621731682 - (TX) EL PASO ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $393.00 | 1992777643 - CAPE CORAL FT MYERS ENDOSCOPY ASC LLC, GULF COAST ENDOSCOPY CENTER SOUTH | 621767599 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $1064.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61530 | $3258.00 | 1346249604 - ST. MARY'S SURGICAL CENTER LLC, ST. MARY'S SURGICAL CENTER | 201685516 - (MO) ST MARYS SURGICAL CENTER LLC | MO | 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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