CPT 61537 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 • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61537 |
National average reimbursement for CPT 61537 by major payers:
$3,232.95
$3,293.14
$3,480.53
$3,977.87
| 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 61537 | ||||||
United | 61537 | $410.00 | 1194326785 - TEXAS PARTNERS CENTER LLC | 853236752 - (TX) TEXAS PARTNERS CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $750.00 | 1376884585 - ADVANCED UROLOGY SURGERY CENTER | 461456287 - (GA) ADVANCED UROLOGY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $983.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $500.00 | 1790265999 - MUVE | 822351627 - (PA) MUVE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $329.00 | 1891951885 - MISSISSIPPI EYE SURGERY CENTER, MISSISSIPPI EYE SURGERY CENTER FACILITY | 770619942 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1428.00 | 1639783335 - ADVANCED SURGICAL CARE OF WYOMING, LLC | 843562014 - (WY) ADVANCED SURGICAL CARE OF WYOMING LLC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1028.00 | 1134613979 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $688.00 | 1740288679 - GULF COAST SURGICAL PARTNERS LLC | 631285913 - (AL) GULF COAST SURGICAL PARTNERS LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $700.00 | 1558792598 - PARIS SURGERY CENTER, LLC | 461871794 - (TX) PARIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $920.00 | 1417278011 - WILSHIRE SURGERY CENTER, LLC | 270616665 - (OR) WILSHIRE SURGERY CENTER | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1124.00 | 1508438375 - BSC REID PARK LLC | 870858924 - (AZ) BSC REID PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $100.00 | 1588665269 - RF EYE PC, COCHISE EYE & LASER ASC | 860879991 - (AZ) R.F. EYE, PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $475.00 | 1700282852 - LAKE JACKSON ENDOSCOPY CENTER, LP. | 800513571 - (TX) LAKE JACKSON ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $880.00 | 1205080181 - NORTHWEST NEUROSPINE INSTITUTE, LLC, TWO RIVERS SURGICAL CENTER | 300474327 - (OR) NORTHWEST NEUROSPINE INSTITUTE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $578.00 | 1578881009 - EYE LASER AND SURGERY CENTER LLC | 272376757 - (OH) EYE LASER AND SURGERY CENTER LLC | OH | 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 61537 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61537 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 61537 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 |
|---|---|---|
| 61536-CPT | High | Craniotomy With Elevation Of Bone Flap; For Excision Of Cerebral Epileptogenic Focus, With Electrocorticography During Surgery (Includes Removal Of Electrode Array) |
| 61537-CPT | High | Craniotomy With Elevation Of Bone Flap; For Lobectomy, Temporal Lobe, Without Electrocorticography During Surgery |
| 61538-CPT | High | Craniectomy, Trephination, Bone Flap Craniotomy; For Lobectomy, Temporal Lobe, With Electrocorticography During Surgery, Temporal Lobe |
| 61539-CPT | High | Craniotomy With Elevation Of Bone Flap; For Lobectomy Other Than Temporal Lobe Partial Or Total With Electrocorticograpghy During Surgery (Rvsd 1/1/04) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61537. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61537 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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