CPT 61540 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 • AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61540 |
National average reimbursement for CPT 61540 by major payers:
$2,942.19
$2,992.65
$3,011.80
$3,590.52
| 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 61540 | ||||||
United | 61540 | $1064.00 | 1659748184 - SURGCENTER OF THE POTOMAC, LLC | 472311914 - (MD) SURGCENTER OF THE POTOMAC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $564.00 | 1720024284 - PMA SURGERY CENTER, LLC | 721550480 - (TN) PMA SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $345.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $812.00 | 1831217231 - THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | 205430025 - (OH) THE ENDOSCOPY CENTER AT BAINBRIDGE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $597.00 | 1265462881 - WOOSTER OPHTHALMOLOGISTS, INC., EYE SURGERY CENTER OF WOOSTER | 341338984 - (OH) WOOSTER OPHTHALMOLOGISTS, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $983.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 10735856 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $424.00 | 1255390670 - CARROLL COUNTY EYE SURGERY CENTER, LLC | 50576667 - (MD) CARROLL COUNTY EYE SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $750.00 | 1609965961 - BROOKINGS AMBULATORY SURGERY CENTER, LLP | 203272258 - (SD) BROOKINGS AMBULATORY SURGERY CENTER LLP | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $1028.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $300.00 | 1033115472 - CAPLAN-BERKELEY, LLP, CAPLAN SURGERY CENTER | 571146952 - (TX) CAPLANBERKELEY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $357.00 | 1659363844 - LASER & SURGERY CENTER OF ACADIANA | 721288671 - (LA) LASER SURGERY CENTER OF ACADIANA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $500.00 | 1881687614 - TURKS HEAD SURGERY CENTER LLC | 200184603 - (PA) TURK'S HEAD SURGERY CENTER, L.L.C. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $485.00 | 1750333746 - NORTH PINELLAS SURGERY CENTER LLC | 593759228 - (FL) NORTH PINELLAS SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $420.00 | 1447319603 - NORTHERN BALTIMORE SURGERY CENTER, LLC | 522234559 - (MD) NORTHERN BALTIMORE SURGERY CENTER 401(K) PLAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $643.00 | 1801349386 - INTERVENTIONAL PAIN MANAGEMENT, LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | 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 61540 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61540 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 61540 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 |
| 61540-CPT | High | Craniotomy With Elevation Of Bone Flap; For Lobectomy, Other Than Temporal Lobe, Partial Or Total, Without Electrocorticography During Surgery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61540 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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