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See a sample rate comparisonCPT 61543 Fee Schedule
Last Verified: October 2026
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.
Craniotomy With Elevation Of B, Craniotomy With Elevation Of Bone Flap For Partial Orsubtotal Hemispherectomy Craniotomy With Elevation Of Bone Flap For Partial Or
| 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 51 - Multiple procedures AG - Primary physician GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61543 |
| Medicaid Fee Schedule | View Medicaid rates for 61543 |
National average reimbursement for CPT 61543 by major payers:
$2,753.18
$2,951.06
$3,030.05
$3,457.71
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CPT 61543
5 of 25 sample ratesHigher to lower in this preview
Mclean Ambulatory Surgery, LLC
Mclean Ambulatory Surgery LLC
$4,165.00Published rateKleinert Kutz Surgery Center, LLC
Kleinert Kutz Surgery Center LLC
$1,075.00Published rateSurgery Center Of Gilbert LLC, Surgery Center Of Gilbert
Surgery Center Of Gilbert, LLC
$1,007.00Published rateTexoma Surgery Center LLC
$410.00Published rateAdvanced Laser & Surgicenter Of Arizona, PC
$100.00Published rate
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See a sample payer proposalCPT 61543 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61543 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 61543 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 |
|---|---|---|
| 61537-CPT | High | Craniotomy With Elevation Of B, Craniotomy With Elevation Of Bone Flapfor Lob- Ectomy Temporal Lobe Without Electrocorticography During Surgery |
| 61543-CPT | High | Craniotomy With Elevation Of B, Craniotomy With Elevation Of Bone Flap For Partial Orsubtotal Hemispherectomy Craniotomy With Elevation Of Bone Flap For Partial Or |
| 61544-CPT | High | Craniotomy With Elevation Of B, Craniotomy With Elevation Of Bone Flap For Excision Orcoagulation Of Choroid Plexus Craniotomy With Elevation Of Bone Flap For Excision Or |
| 61545-CPT | High | Craniotomy With Elevation Of B, Craniotomy With Elevation Of Bone Flap For Excision Ofcraniopharyngioma Craniotomy With Elevation Of Bone Flap For Excision Of |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61543. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61543 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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