CPT 61534 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 |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61534 |
National average reimbursement for CPT 61534 by major payers:
$2,087.79
$2,230.88
$2,322.44
$2,699.83
| 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 61534 | ||||||
United | 61534 | $494.50 | 1700967106 - EBSC, LLC, SURGICAL CARE CENTER OF MICHIGAN | 382840421 - (MI) EBSC LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $550.00 | 1558327213 - SURGICARE OF JACKSON LTD | 752162993 - (MS) SURGICARE OF JACKSON LTD | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $750.00 | 1003802950 - MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC | 550837369 - (MN) MINNESOTA EYE INSTITUTE SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $1207.00 | 1124125331 - AMBULATORY SURGERY ASSOCIATES, LLC, BROOKSIDE SURGERY CENTER | 383237596 - (MI) AMBULATORY SURGERY ASSOCIATES | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $724.00 | 1194790808 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $983.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $6659.00 | 1326286360 - NORTH CAMPUS SURGERY CENTER LLC | 352147088 - (IN) NORTH CAMPUS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $1064.00 | 1245427228 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $650.00 | 1467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER | 204413058 - (WA) SOUTH SOUND SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $912.00 | 1588328918 - HARLEM ROAD AMBULATORY SURGERY CENTER LLC | 833648797 - (NY) HARLEM ROAD AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $1049.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $7071.00 | 1235195033 - NORTH COAST SURGERY CENTER LTD | 752448928 - (CA) NORTH COAST SURGERY CENTER LTD | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $100.00 | 1073030532 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $528.00 | 1437601200 - UROPARTNERS SURGERY CENTER, LLC | 814131096 - (IL) UROPARTNERS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61534 | $170.00 | 1972147239 - CHILDREN'S SURGERY CENTER OF PHILADELPHIA LLC, CHILDREN'S DENTAL SURGERY OF PHILADELPHIA | 842886610 - (PA) CHILDRENS SURGERY CENTER OF PHILADELPHIA LLC | PA | 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 61534 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61534 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 61534 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 |
|---|---|---|
| 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 |
| 61533-CPT | High | Craniotomy With Elevation Of Bone Flap; For Subdural Implantation Of An Electrode Array, For Long-Term Seizure Monitoring- Rn Review=12/8/2007-9/13/2021 |
| 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 61534. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61534 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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