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 |
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 | $633.00 | 1235106782 - VALLEY SURGERY CENTER AT MODESTO, LLC, VALLEY SURGERY CENTER, LP | 200160879 - (CA) VALLEY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $605.00 | 1336366442 - CASTLE HILLS OUTPATIENT CENTER, INC., SURGICAL ARTS CENTER | 742931255 - (TX) CASTLE HILLS OUTPATIENT CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $1236.00 | 1861041139 - KADLEC REGIONAL MEDICAL CENTER, KADLEC AMBULATORY ENDOSCOPY CENTER, LEE CAMPUS | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $1215.00 | 1780613521 - LITCHFIELD HILLS SURGERY CENTER | 562441789 - (CT) LITCHFIELD HILLS SURGERY CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $1064.00 | 1417377649 - PACIFIC ENDOSCOPY CENTER LLC | 203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLC | HI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $500.00 | 1225387640 - PCET SURGERY CENTER LLC | 454288531 - (TN) PCET SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $2172.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | 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 | 61540 | $2336.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $1199.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $2387.00 | 1356643944 - UNION SURGERY CENTER, LLC | 272373691 - (NJ) UNION SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $350.00 | 1417333295 - IDOX3 LLC, TRI-STATE SURGERY CENTER | 473757893 - (OH) IDOX3 LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61540 | $653.00 | 1255607628 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, PC, ALLSPINE SURGERY CENTER | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | 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 | $479.00 | 1073888103 - SURGERY BY VOLD VISION | 454504788 - (AR) SURGERY BY VOLD VISION | AR | 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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