CPT 61586 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 • 11 - Office |
| Common Modifiers | • None • 62 - Co-Surgeons • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61586 |
National average reimbursement for CPT 61586 by major payers:
$2,967.85
$3,241.19
$3,403.32
$4,067.72
| 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 61586 | ||||||
United | 61586 | $1444.00 | 1730401571 - CHILDRENS SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER MAITLAND | 262389638 - (FL) CHILDRENS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $982.00 | 1538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC | 205170962 - (CA) PHYSICIANS SURGERY CENTER OF | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $261.00 | 1124093588 - UROLOGY SURGERY CENTER OF SAVANNAH, LLLP, UROLOGY SURGERY CENTER, LLP | 582511751 - (GA) UROLOGY SURGERY CENTER OF SAVANNAH LLLP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $1146.00 | 1114549805 - BSC 1 LLC | 851036387 - (AZ) BSC 1 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $384.00 | 1871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA | 834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $317.00 | 1649270075 - NORTHEAST REGIONAL SURGERY CENTER LLC | 200159751 - (PA) NORTHEAST REGIONAL SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $576.00 | 1467490433 - UROLOGY SURGICAL CENTER LLC | 470814279 - (NE) UROLOGY SURGICAL CENTER | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $4893.00 | 1497312540 - MEMORIAL HERMANN SURGERY CENTER MAIN STREET, LLC | 384114079 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $109.00 | 1073588356 - DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA, LLC | 201456252 - (AZ) DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $1405.00 | 1679235584 - ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC | 872158427 - (MN) ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $1028.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $1043.00 | 1154322410 - SUMMIT SURGICAL SUITES, LLC, SOUTHWEST SURGICAL SUITES | 383641574 - (IN) SUMMIT SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $2200.00 | 1073545299 - OREGON OUTPATIENT SURGERY CENTER LLC | 223883387 - (OR) OREGON OUTPATIENT SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $16236.00 | 1497393516 - AURORA SURGERY CENTERS, LLC, AURORA PLEASANT PRAIRIE AMBULATORY SURGERY CENTER | 811401714 - (WI) AURORA SURGERY CENTERS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61586 | $1028.00 | 1083938765 - MEDICAL PARK TOWER SURGERY CENTER, LLC, MEDICAL PARK TOWER SURGERY CENTER | 270543475 - (TX) MEDICAL PARK TOWER SURGERY CENTER 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 |
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CPT 61586 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61586 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 61586 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 |
|---|---|---|
| 61580-CPT | High | Craniofacial Approach To Anterior Cranial Fossa; Extradural, Including Lateral Rhinotomy, Ethmoidectomy, Sphenoidectomy, Without Maxillectomy Or Orbital Exenteration |
| 61581-CPT | High | Craniofacial Approach To Anterior Cranial Fossa; Extradural, Including Lateral Rhinotomy, Orbital Exenteration, Ethmoidectomy, Sphenoidectomy And/Or Maxillectomy |
| 61582-CPT | High | Craniofacial Approach To Anterior Cranial Fossa; Extradural, Including Unilateral Or Bifrontal Craniotomy, Elevation Of Frontal Lobe(S), Osteotomy Of Base Of Anterior Cranial Fossa |
| 61586-CPT | High | Bicoronal, Transzygomatic And/Or Lefort I Osteotomy Approach To Anterior Cranial Fossa With Or Without Internal Fixation, Without Bone Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61586. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61586 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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