CPT 61539 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 • 23 - Emergency Room |
| Common Modifiers | • None • 51 - Multiple procedures • 78 - Return to OR - related procedure |
| Complexity Level | High |
National average reimbursement for CPT 61539 by major payers:
$2,892.50
$3,225.29
$3,280.98
$3,870.67
| 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 61539 | ||||||
United | 61539 | $750.00 | 1194960732 - ISURGERY, LLC | 300514883 - (SD) ISURGERY LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $1000.00 | 1700546629 - STONE OAK SURGICENTER, LLC | 873925488 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $622.00 | 1497706626 - CHICAGO PROSTATE CANCER SURGERY CENTER, LLC, DUPAGE MEDICAL GROUP SURGERY CENTER, WESTMONT | 204403852 - (IL) CHICAGO PROSTATE CANCER SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $662.00 | 1467101907 - PEACE RIVER SURGERY CENTER | 853047089 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $436.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $1064.00 | 1598767154 - NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER, LLC | 582132641 - (GA) NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $4614.00 | 1730834730 - HERITAGE DEVELOPMENT PARTNERS, LLC, ORTHOPAEDIC SURGERY CENTER | 882720151 - (KY) HERITAGE DEVELOPMENT PARTNERS LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $375.00 | 1306843867 - PALM BEACH OUTPATIENT SURGICAL CENTER, LLC, PALM BEACH OUTPATIENT SURGICAL CENTER | 900133346 - (FL) PALM BEACH OUTPATIENT SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $518.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $536.00 | 1477586576 - BUFFALO AMBULATORY SERVICES, INC, BUFFALO AMBULATORY SURGERY CENTER | 161348390 - (NY) BUFFALO AMBULATORY SERVICES, INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $444.00 | 1275507527 - ENDOSCOPY CENTER OF NORTHWEST CONNECTICUT | 61609993 - (CT) ENDOSCOPY CENTER OF NORTHWEST CT | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $97.00 | 1992735286 - CASTLEMAN SURGERY CENTER, LLC, SOUTHGATE SURGERY CENTER | 383029505 - (MI) CASTLEMAN SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $428.00 | 1962459610 - CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | 752477808 - (TX) CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $1146.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61539 | $1793.00 | 1427044452 - THE SURGERY CENTER AT SELF MEMORIAL HOSPITAL, LLC, SURGERY CENTER OF THE LAKELANDS | 571087792 - (SC) THE SURGERY CENTER AT SELF MEM | SC | 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 61539 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61539 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 61539 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 61539. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61539 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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