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 |
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 | $1082.00 | 1164561064 - HUNTERDON CENTER FOR SURGERY, LLC, SURGERY TODAY | 223401213 - (NJ) HUNTERDON CENTER FOR SURGERY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1955.00 | 1386882587 - BAYLOR SURGICARE AT GRANBURY LLC, BAYLOR SCOTT & WHITE SURGICARE-GRANBURY | 263896477 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $2044.00 | 1336538297 - MINNETONKA AMBULATORY SURGERY CENTER LLC | 465653486 - (MN) MINNETONKA AMBULATORY SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $580.00 | 1346349164 - SOUTHERN ALABAMA SURGERY CENTER LLC, SURGERY CENTER SOUTH | 621827534 - (AL) SOUTHERN ALABAMA SURGERY CENTER, LL | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1064.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $500.00 | 1750456539 - WIREGRASS RANCH ASC HOLDINGS, WIREGRASS RANCH AMBULATORY SURGERY CENTER | 991010158 - (FL) WIREGRASS RANCH ASC HOLDINGS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $579.00 | 1336138635 - EYE SURGICAL SPECIALISTS OF NEW JERSEY, SURGERY CENTER OF CENTRAL NEW JERSEY | 223411416 - (NJ) EYE SURGICAL SPECIALISTS OF NEW JERSEY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $972.00 | 1629079058 - CARES SURGICENTER LLC | 223557777 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $410.00 | 1104457274 - TEXAS MIDWEST ENDOSCOPY CENTER, LLC | 842574842 - (TX) TEXAS MIDWEST ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $900.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1028.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $570.00 | 1922003052 - EAST OREGON SURGERY CENTER, LLC | 200209992 - (OR) EAST OREGON SUREGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $1274.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $286.00 | 1770570467 - DELAWARE EYE SURGERY CENTER, LLC | 510412455 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61566 | $312.00 | 1902832405 - COASTAL SURGERY CENTER, LLC | 202667835 - (FL) COASTAL SURGERY CENTER LLC | FL | 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 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.
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