Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 61564 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.
Excision Intra And Extracrani, Excision Intra And Extracranial Benign Tumor Of Cranialbone (Eg Fibrous Dysplasia) With Optic Nerve Decompression Excision Intra And Extracranial Benign Tumor Of Cranial
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61564 |
| Medicaid Fee Schedule | View Medicaid rates for 61564 |
National average reimbursement for CPT 61564 by major payers:
$3,167.33
$3,281.22
$3,269.15
$3,938.04
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 61564.
CPT 61564
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Cleburne
$9,124.00Published rateSan Ramon Endoscopy Center Inc
$1,274.00Published rateSurgery Center At Grove Creek, LLC
Surgery Center At Grove Creek LLC
$840.00Published rateNaeem M Akhtar, Madera Ambulatory Endoscopy Center
Naeem M. Akhtar, M.D.
$658.00Published rateGynemed Surgical Center
$280.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 61564 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61564 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 61564 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 |
|---|---|---|
| 61563-CPT | High | Excision Of Skull Tumor, Excision Intra And Extracranial Benign Tumor Of Cranial Bone Eg Fibrous Dysplasia Without Optic Nerve Decompression |
| 61564-CPT | High | Excision Intra And Extracrani, Excision Intra And Extracranial Benign Tumor Of Cranialbone (Eg Fibrous Dysplasia) With Optic Nerve Decompression Excision Intra And Extracranial Benign Tumor Of Cranial |
| 61570-CPT | High | Craniectomy Or Craniotomy Wit, Craniectomy Or Craniotomy With Excision Of Foreign Bodyfrom Brain Craniectomy Or Craniotomy With Excision Of Foreign Body |
| 61571-CPT | High | Craniectomy Or Craniotomy Wit, Craniectomy Or Craniotomy With Treatment Of Penetratingwound Of Brain Craniectomy Or Craniotomy With Treatment Of Penetrating |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61564. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61564 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61564) and we'll show you how you compare in 15 minutes or less.