CPT 61567 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 • 11 - Office |
| Common Modifiers | • None • 22 - Increased Procedural Services • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61567 |
National average reimbursement for CPT 61567 by major payers:
$3,207.32
$3,471.13
$3,487.80
$4,172.63
| 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 61567 | ||||||
United | 61567 | $1100.00 | 1861458507 - BRASS PARTNERSHIP IN COMMENDAM | 721097827 - (LA) BRASS PARTNERSHIP IN COMMENDAM | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $1344.00 | 1780747394 - MORRIS AVENUE ENDOSCOPY LLC | 223651957 - (NJ) MORRIS AVENUE ENDOSCOPY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $1049.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $581.00 | 1356359632 - ENDOSCOPY CENTER OF NORTH MISSISSIPPI,LLC | 640915368 - (MS) ENDOSCOPY CENTER OF NORTH MISSISSIPPILLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $180.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $477.00 | 1831109875 - M-S SURGERY CENTER LLC | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $650.00 | 1174634778 - THE CENTER FOR SPECIALIZED SURGERY, LP | 203364256 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $1064.00 | 1962714154 - SURGCENTER OF WHITE MARSH, LLC | 272873637 - (MD) SURGCENTER OF WHITE MARSH, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $724.00 | 1144416587 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $249.00 | 1891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER | 853605981 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $2172.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $430.00 | 1639142656 - GREENSBORO OPHTHALMOLOGY ASC LLC, SURGICAL EYE CENTER | 621842511 - (NC) GREENSBORO OPHTHALMOLOGY LLC, ASC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $1227.00 | 1023182086 - EAST TEXAS MEDICAL CENTER CARTHAGE, ETMC CARTHAGE | 824037220 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $464.00 | 1972850808 - LAKE RIDGE AMBULATORY SURGERY CENTER, LLC, LAKE RIDGE SURGERY CENTER | 455347932 - (VA) LAKE RIDGE AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61567 | $565.00 | 1649791641 - NORTHEAST ATLANTA VASCULAR CARE, LLC | 453857751 - (GA) NORTHEAST ATLANTA VASCULAR CARE LLC | GA | 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 61567 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61567 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 61567 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 |
| 61531-CPT | High | Subdural Implantation Of Strip Electrodes Through One Or More Burr Or Trephine Hole(S) For Long Term Seizure Monitori |
| 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 61567. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61567 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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