CPT 61575 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 • 80 - Assistant surgeon • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61575 |
National average reimbursement for CPT 61575 by major payers:
$3,136.10
$3,364.27
$3,394.34
$4,064.18
| 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 61575 | ||||||
United | 61575 | $410.00 | 1285171538 - EYE 35 ASC. LLC | 814995275 - (TX) EYE 35 ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $750.00 | 1801811443 - PHYSICIANS OF WINTER HAVEN LLC, DAY SURGERY CENTER | 200324393 - (FL) PHYSICIANS OF WINTER HAVEN, LLC DBA DAY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $122.00 | 1144497264 - CALIFORNIA SKIN SURGERY CENTER INC | 262564861 - (CA) CALIFORNIA SKIN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $317.00 | 1649270075 - NORTHEAST REGIONAL SURGERY CENTER LLC | 200159751 - (PA) NORTHEAST REGIONAL SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $2705.00 | 1528339447 - CP SURGERY CENTER, LLC | 800776412 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $562.00 | 1750169975 - UNOVA ASC, INC | 812495096 - (FL) UNOVA ASC INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $500.00 | 1750383295 - EYE SURGERY CENTER OF SAINT AUGUSTINE INC | 200127648 - (FL) EYE SURGERY CENTER OF SAINT AUGUSTINE INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $721.00 | 1215263082 - NCBH OUTPATIENT ENDOSCOPY CENTER, L.L.C., WFUBMC ENDOSCOPY CENTER | 270668137 - (NC) NCBH OUTPATIENT ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $595.00 | 1295973006 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC, SUMMIT SURGERY CENTER AT ST. MARYS GALENA | 264094998 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC D/B/A SUMMIT | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $702.00 | 1558480947 - ISSAQUAH FOOT & ANKLE SPECIALISTS PLLC | 454029230 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $2785.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $900.00 | 1538167978 - VALLEY SURGICAL CENTER LTD, VALLEY SURGERY CENTER | 300035229 - (OH) VALLEY SURGICAL CENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $1146.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $976.00 | 1598039125 - ROOSEVELT SURGERY CENTER, LLC | 271778024 - (NY) ROOSEVELT SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61575 | $495.00 | 1376797332 - RENUE SURGERY CENTER LLC | 262423545 - (GA) RENUE SURGERY CENTER 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 61575 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61575 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 61575 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 |
|---|---|---|
| 61575-CPT | High | Transoral App-Bx,Decompress/Les.Exc |
| 61576-CPT | High | Transoral Approach To Skull Base, Brain Stem Or Upper Spinal Cord For Biopsy, Decompression Or Excision Of Lesion; Requiring Splitting Of Tongue And/Or Mandible (Including Tracheostomy) |
| 61590-CPT | High | Infratemporal Pre-Auricular Approach To Middle Cranial Fossa (Parapharyngeal Space Infratemporal And Midline Skull Base Nasopharynx) With Or Without Disarticulation Of The Mandible Including Parotidectomy Craniotomy Decompression And/Or Mobilization Of The Facial Nerve And/Or Petrous Carotid Artery |
| 61595-CPT | High | Transtemporal Approach To Posterior Cranial Fossa, Jugular Foramen Or Midline Skull Base, Including Mastoidectomy, Decompression Of Sigmoid Sinus And/Or Facial Nerve, With Or Without Mobilization |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61575. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61575 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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