CPT 61576 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 |
| Common Modifiers | • None • 62 - Co-Surgeons |
| Complexity Level | High |
National average reimbursement for CPT 61576 by major payers:
$4,760.39
$5,377.28
$5,517.31
$6,574.16
| 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 61576 | ||||||
United | 61576 | $9124.00 | 1538292990 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1064.00 | 1326527680 - INTRACOASTAL SURGERY CENTER, LLC | 824525706 - (FL) INTRACOASTAL SURGERY CENTER LL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $2705.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $580.00 | 1679939318 - CRATER LAKE SURGERY CENTER LLC | 475641623 - (OR) CRATER LAKE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1049.00 | 1780128553 - CAROLINAS ENDOSCOPY CENTER LLC | 814599818 - CAROLINAS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $357.00 | 1659363844 - LASER & SURGERY CENTER OF ACADIANA | 721288671 - (LA) LASER SURGERY CENTER OF ACADIANA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1049.00 | 1942851639 - NORTHERN MICHIGAN SURGICAL SUITES, LLC | 830670803 - (MI) NORTHERN MICHIGAN SURGICAL SUITES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1367.00 | 1326094491 - PROLIANCE SURGEONS INC PS, PROLIANCE CENTER FOR SPECIALTY SURGERY | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1064.00 | 1952333882 - THE MARYLAND CENTER FOR DIGESTIVE HEALTH LLC | 470856276 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $2575.00 | 1477594422 - SURGERY CENTER OF AVENTURA LTD | 113765789 - (FL) SURGERY CENTER OF AVENTURA LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $1344.00 | 1780747394 - MORRIS AVENUE ENDOSCOPY LLC | 223651957 - (NJ) MORRIS AVENUE ENDOSCOPY, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $408.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $283.00 | 1922316835 - INDEPENDENT SURGERY CENTER LLC | 272764590 - (WI) INDEPENDENT SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $936.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61576 | $402.00 | 1083601298 - LAHAYE CENTER FOR ADVANCED EYE CARE, APMC, LAHAYE EYE CLINIC | 720988221 - (LA) LAHAYE EYE CLINIC, P.C. | LA | 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 61576 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61576 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 61576 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 61576. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61576 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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