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CPT 61556 Fee Schedule

Last Verified: January 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.

Craniotom. For Craniosyn;Bne Flp
Key FactDetail
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

22 - Increased Procedural Services

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 61556

National average reimbursement for CPT 61556 by major payers:

bcbs

$2,071.60

uhc

$2,281.94

aetna

$2,343.65

cigna

$2,773.17

Preview provider-level rates for...
For billing codeCPT 61556
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 61556

United
61556$350.001225221435 - GALLERIA SURGERY CENTER LLC731713874 - (MD) GALLERIA SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$6068.001093120859 - PARK HILL SURGERY CENTER, LLC451484375 - (TX) PARK HILL SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$675.001851055362 - SAND PLASTIC SURGERY, PLLC, SIXTH AVENUE SURGERY CENTER871494902 - (WA) SAND PLASTIC SURGERY PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$250.001124484019 - EDISON SURGERY CENTER LLC475016492 - (NJ) EDISON SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$350.001578914891 - DH PHYSICIANS AMBULATORY SERVICES812885619PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$1096.001104933696 - WEST LAKES SURGERY CENTER LLC205345295 - (IA) WEST LAKES SURGERY CENTER, LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$700.001114552338 - GEORGIA INTERVENTIONAL PAIN842028147 - (GA) GEORGIA INTERVENTIONAL PAINGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$812.001477242154 - PLYMOUTH ORTHOPEDIC SURGERY CENTER LLC, PLYMOUTH ORTHOPEDIC SURGERY CENTER883632673 - (MN) PLYMOUTH ORTHOPEDIC SURGERY CENTER LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$400.001265465025 - GEORGIA SURGICAL CENTERS INC43650858GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$307.001922016898 - JAMES TRICE MD PA, DIGESTIVE DISEASE CENTER710758882ARAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$1167.001104082692 - OLD TESSON SURGERY CENTER, L.P., OLD TESSON SURGERY CENTER262876334 - (MO) OLD TESSON SURGERY CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$1064.001063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER862679471TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$459.001295088292 - CADENCE AMBULATORY SURGERY CENTER, LLC800838376ILAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$1080.001336268754 - MOUNTAIN VISTA ORTHOPAEDIC SURGERY CENTER, LLC710936920COAmbulatory Surgical Clinic/Center (261QA1903X)
United
61556$437.001083796221 - SOUTHERN INDIANA SURGERY CENTER, LLC, SOUTHERN INDIANA SURGERY CENTER351829838 - (IN) SOUTHERN INDIANA SURGERY CENTERINAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 61556 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 61556 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 61556 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.

CodeComplexityDescription
61550-CPTHighCraniect. For Craniosyn.;1 Sut
61552-CPTHighCraniectomy Strip Multiple 1 Stage
61556-CPTHighCraniotom. For Craniosyn;Bne Flp
61557-CPTHighCraniotom. For Craniosynostosis;Bifronta

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 61556 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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