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See a sample rate comparisonCPT 61558 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.
Surgery To Reshape Skull, Surgery To Reshape The Final Form Of The Skull. The Procedure Involves Removing A Portion Of The Skull And Trimming Or Carving The Bone. One Or More Bone Grafts May Be Used If The Procedure Is Complex.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 62 - Co-Surgeons AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61558 |
| Medicaid Fee Schedule | View Medicaid rates for 61558 |
National average reimbursement for CPT 61558 by major payers:
$2,323.38
$2,490.37
$2,594.87
$2,959.28
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CPT 61558
5 of 25 sample ratesHigher to lower in this preview
Surgery Center, LLC
The Surgery Center, LLC
$16,050.00Published rateSanta Barbara Surgery Center Lp
$1,274.00Published rateEnti Surgery Center LLC
$834.00Published rateInnovative Surgery Center, LLC
Innovative Surgery Center LLC
$553.00Published rateSouthern Surgical Center, LLC
Southern Surgical Center LLC
$275.00Published rate
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See a sample payer proposalCPT 61558 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61558 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 61558 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 |
|---|---|---|
| 61550-CPT | High | Surgery To Reshape Skull, Surgery To Reshape The Final Form Of The Skull. The Procedure Involves Removing A Portion Of The Skull And Trimming Or Carving The Bone. One Or More Bone Grafts May Be Used If The Procedure Is Complex. |
| 61556-CPT | High | Surgery To Reshape Skull, Surgery To Reshape The Final Form Of The Skull. The Procedure Involves Removing A Portion Of The Skull And Trimming Or Carving The Bone. One Or More Bone Grafts May Be Used If The Procedure Is Complex. |
| 61557-CPT | High | Surgery To Reshape Skull, Surgery To Reshape The Final Form Of The Skull. The Procedure Involves Removing A Portion Of The Skull And Trimming Or Carving The Bone. One Or More Bone Grafts May Be Used If The Procedure Is Complex. |
| 61558-CPT | High | Surgery To Reshape Skull, Surgery To Reshape The Final Form Of The Skull. The Procedure Involves Removing A Portion Of The Skull And Trimming Or Carving The Bone. One Or More Bone Grafts May Be Used If The Procedure Is Complex. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61558 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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