CPT 61566 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 • GC - Service performed by resident under supervision • 78 - Return to OR - related procedure • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61566 |
National average reimbursement for CPT 61566 by major payers:
$2,914.90
$3,066.32
$3,128.19
$3,685.40
| 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 61566 | ||||||
United | 61566 | $376.00 | 1740413400 - ATLANTIC SURGERY & LASER CENTER LLC | 262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $4825.00 | 1447489695 - AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, L.L.C., VIRTUA CENTER FOR SURGERY | 208643005 - (NJ) AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1752.00 | 1053565259 - SOUTHWEST LINCOLN SURGERY CENTER, LLC, SOUTHWEST LINCOLN SURGERY CENTER | 262981972 - (NE) SOUTHWEST LINCOLN SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1348.00 | 1912090432 - MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE, LLC | 812557673 - (DC) MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE LLC | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $535.00 | 1023373628 - EYES ON STARK SURGERY CENTER, LLC, VISTA SURGICAL CENTER | 451114025 - (OH) EYES ON STARK SURGERY CENTER, LLC DBA VISTA SURGICAL CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $408.00 | 1457968430 - PARK VENTURA ENDOSCOPY CENTER, LLC, DIGESTIVE HEALTH CENTER OF ALLEN | 412059014 - (TX) PARK VENTURA ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1030.00 | 1750838801 - MEMORIAL HOUSTON SURGERY CENTER, LLC, MEMORIAL HOUSTON SURGERY CENTER | 371782795 - (TX) MEMORIAL HOUSTON SURGERY CENTER, | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1064.00 | 1760491385 - ENDOSCOPY CENTER OF NORTHERN OHIO, LLC | 341966846 - (OH) ENDOSCOPY CENTER OF NORTHERN OHIO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $245.00 | 1174067318 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1028.00 | 1134613979 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $983.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $650.00 | 1467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER | 204413058 - (WA) SOUTH SOUND SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $283.00 | 1467089599 - CONWAY AMBULATORY SURGERY CENTER, LLC | 832516939 - (AR) CONWAY AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $570.00 | 1720359151 - ST JOHN SURGERY CENTER INC | 454271780 - (CA) ST JOHN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $747.00 | 1871169136 - WICHITA FALLS SPECIALTY ASC LLC, MOMENTUM SPECIALTY SURGERY CENTER | 842950505 - (TX) WICHITA FALLS SPECIALTY ASC LLC | TX | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 61566 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61566 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 61566 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 |
|---|---|---|
| 61530-CPT | High | Craniectomy, Bone Flap Craniotomy, Transtemporal (Mastoid) For Excision Of Cerebellopontine Angle Tumor; Combined With Middle/Posterior Fossa Craniotomy/Craniectomy |
| 61533-CPT | High | Craniotomy With Elevation Of Bone Flap; For Subdural Implantation Of An Electrode Array, For Long-Term Seizure Monitoring- Rn Review=12/8/2007-9/13/2021 |
| 61566-CPT | High | Craniotomy With Elevation Of Bone Flap; For Selective Amygdalohippocampectomy |
| 61567-CPT | High | Craniotomy With Elevation Of Bone Flap; For Multiple Subpial Transections With Electrocorticography During Surgery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61566. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61566 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61566) and we'll show you how you compare in 15 minutes or less.