CPT 61535 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 | • 58 - Staged or related procedure during postoperative period • None • 52 - Reduced Services |
| Complexity Level | High |
National average reimbursement for CPT 61535 by major payers:
$1,273.50
$1,345.71
$1,431.14
$1,649.66
| 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 61535 | ||||||
United | 61535 | $789.00 | 1881031235 - KEARNEY PAIN TREATMENT CENTER, LLC | 461807684 - (NE) KEARNEY PAIN TREATMENT CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $107.00 | 1073588356 - DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA, LLC | 201456252 - (AZ) DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $700.00 | 1356969703 - VASCULAR LABS OF THE ROCKIES ASC, LLC | 850780051 - (CO) VASCULAR LABS OF THE ROCKIES ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $2732.00 | 1710910922 - SURGERY CENTER OF INDEPENDENCE LP | 200670748 - (MO) SURGERY CENTER OF INDEPENDENCE LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $112.00 | 1235102344 - THE HARLINGEN ENDOSCOPY CENTER LP, VALLEY ENDOSCOPY CENTER | 621839180 - (TX) THE HARLINGEN ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $1064.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $974.00 | 1316940539 - GRAND ISLAND SURGICAL CENTER LLC | 470811846 - (NE) GRAND ISLAND SURGICAL CENTER, L.L.C. | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $637.00 | 1649925801 - MUSIC CITY SURGERY CENTER, LLC | 872654999 - (TN) MUSIC CITY SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $258.00 | 1326202086 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER | 521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $694.00 | 1548785116 - NEPHROLOGY & INTERNAL MEDICINE, INC., NEPHROLOGY & INTERNAL MEDICINE INC | 351298573 - (IN) NEPHROLOGY & INTERNAL MEDICINE, INC. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $624.00 | 1245471788 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $408.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $310.00 | 1396897260 - LITTLE ROCK FERTILITY CENTER | 861078562 - (AR) LITTLE ROCK FERTILITY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $1757.00 | 1053562959 - PROHEALTH ALIGNED LLC, PROHEALTH CARE MORELAND SURGERY CENTER | 263324572 - (WI) PROHEALTH ALIGNED LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61535 | $970.00 | 1699421024 - INFIRMARY ASC | 871922333 - (AL) INFIRMARY ASC | AL | 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 61535 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61535 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 61535 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 |
|---|---|---|
| 61531-CPT | High | Subdural Implantation Of Strip Electrodes Through One Or More Burr Or Trephine Hole(S) For Long Term Seizure Monitori |
| 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 |
| 61535-CPT | High | Craniotomy With Elevation Of Bone Flap; For Removal Of Epidural Or Subdural Electrode Array, Without Excision Of Cerebral Tissue (Separate Procedure) |
| 61536-CPT | High | Craniotomy With Elevation Of Bone Flap; For Excision Of Cerebral Epileptogenic Focus, With Electrocorticography During Surgery (Includes Removal Of Electrode Array) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61535 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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