CPT 61552 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 • 62 - Co-Surgeons • AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61552 |
National average reimbursement for CPT 61552 by major payers:

$1,748.74

$1,867.69

$2,036.86

$2,315.45
| 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 61552 | ||||||
United | 61552 | $6068.00 | 1619093218 - CLEBURNE SURGICAL CENTER, LLC | 203742012 - (TX) CLEBURNE SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $565.00 | 1740529064 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $5554.00 | 1730146861 - CONROE SURGERY CENTER 2, LLC | 760697645 - (TX) CONROE SURGERY CENTER 2 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $516.00 | 1073598066 - UROLOGY SURGERY CENTER LP | 621543096 - (TN) UROLOGY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $608.00 | 1306093604 - BOX CANYON SURGERY CENTER LLC | 263086826 - (NV) BOX CANYON SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $743.00 | 1730783523 - ORTHOARIZONA SCOTTSDALE ASC, LLC | 843527783 - (AZ) ORTHOARIZONA SCOTTSDALE ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $330.00 | 1497159255 - SURGICAL CENTER OF PONTE VEDRA BEACH, LLC | 472133947 - (FL) SURGICAL CENTER OF PONTE VEDRA B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $1049.00 | 1295344026 - WEST CHESTER SURGICAL SUITES, LLC | 845072006 - (OH) WEST CHESTER SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $576.00 | 1538117841 - SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC, SHELBY AMBULATORY SURGERY AT THE PHYSICIANS CENTER | 203150946 - (AL) SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $400.00 | 1508896705 - TIFTAREA ENDOSCOPY CENTER, INC. | 582394224 - (GA) TIFTAREA ENDOSCOPY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $2347.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $16050.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $450.00 | 1689860124 - PINE GROVE AMBULATORY SURGICAL | 203237578 - (PA) PINE GROVE AMBULATORY SURGICAL | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $2329.00 | 1538189907 - INDEPENDENT PRACTIONERS OF AMERICA, LLC | 450455462 - (ND) INDEPENDENT PRACTITIONERS OF AMERICA, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61552 | $125.00 | 1952820037 - BOWDEN GASTRO ASSOCIATES LLC | 822738390 - (TN) BOWDEN GASTRO ASSOCIATES LLC | TN | 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 61552 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61552 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 61552 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61552 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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