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 |
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 | $850.00 | 1548827637 - HEDWIG ASC, HOUSTON PREMIERSURGERY CENTER THE VILLAGES | 831849530 - (TX) HEDWIG ASC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $655.00 | 1447212337 - PUGET SOUND GASTROENTEROLOGY, PLLC, EVERGREEN ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1456.00 | 1366446189 - PARKWAY SURGERY CENTER, LLC., PARKWAY SURGERY CENTER | 880403777 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $6189.00 | 1275682148 - TEMPLE UNIVERSITY HOSPITAL, INC | 232825878 - (PA) TEMPLE UNIVERSITY HOSPITAL INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $529.00 | 1215522727 - PREMIER 2020, LLC, PREMIER SURGICAL CENTER | 863194124 - (PA) PREMIER 2020 LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1805.00 | 1649534843 - SURGERY CENTER OF WASILLA, LLC | 455023852 - (AK) SURGERY CENTER OF WASILLA LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $580.00 | 1922729847 - PARDEE AMBULATORY SURGERY CENTER LLC, THE SURGERY CENTER AT MILLS RIVER | 853190133 - (NC) PARDEE AMBULATORY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $619.00 | 1376709907 - ARDMORE REGIONAL SURGERY CENTER, LLC | 262814211 - (OK) ARDMORE REGIONAL SURGERY CENTER | OK | 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 | $500.00 | 1265816003 - CLEARVIEW SURGERY CENTER, LLC | 474123527 - (ID) CLEARVIEW SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $399.00 | 1447212535 - REYNOLDS ROAD SURGICAL CENTER LTD, WILDWOOD SURGICAL CENTER | 311569454 - (OH) REYNOLDS ROAD SURGICAL CENTER DBA WILDWOOD SURGICAL CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $1049.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $410.00 | 1194326785 - TEXAS PARTNERS CENTER LLC | 853236752 - (TX) TEXAS PARTNERS CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $400.00 | 1083898605 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC, MIDSOUTH PAIN TREATMENT CENTER, LLC | 261545635 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61537 | $340.00 | 1861449571 - KIRURGS, LLC, SURGEONS' SURGICAL CENTER | 522018568 - (MD) SURGEONS SURGICAL CENTER, LLC | MD | 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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