Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 61596 Fee Schedule
Last Verified: October 2026
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.
Surgery On Back Of The Brain, Surgery On The Back Portion Of The Brain To Remove A Lesion (Mass). The Procedure May Involve Bones Inside The Ear Or Sinuses As Well As Bones In The Spine (Vertebrae). Nerve Or Blood Vessels In The Face May Be Involved In The Procedure.
| 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 23 - Emergency Room |
| Common Modifiers | None 62 - Co-Surgeons 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61596 |
| Medicaid Fee Schedule | View Medicaid rates for 61596 |
National average reimbursement for CPT 61596 by major payers:
$3,372.03
$3,359.79
$3,477.63
$4,034.83
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 61596.
CPT 61596
5 of 25 sample ratesHigher to lower in this preview
Central Ohio Surgical Institute, LLC
Central Ohio Surgical Institute LLC
$12,881.00Published rateTabatha Roberts
Deaconess Hospital Inc
$1,977.50Published rateAdvanced Surgery Center Of Metairie LLC
Advanced Surgery Center Of Metairie
$1,028.00Published rateSpine And Pain Physicians Surgery Center, LLC
Spine And Pain Physicians Surgery Center LLC
$588.00Published rateRiver Forest Surgery Center LLC
$210.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 61596 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61596 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 61596 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 |
|---|---|---|
| 61595-CPT | High | Surgery On Back Of The Brain, Surgery On The Back Portion Of The Brain To Remove A Lesion (Mass). The Procedure May Involve Bones Inside The Ear Or Sinuses As Well As Bones In The Spine (Vertebrae). Nerve Or Blood Vessels In The Face May Be Involved In The Procedure. |
| 61596-CPT | High | Surgery On Back Of The Brain, Surgery On The Back Portion Of The Brain To Remove A Lesion (Mass). The Procedure May Involve Bones Inside The Ear Or Sinuses As Well As Bones In The Spine (Vertebrae). Nerve Or Blood Vessels In The Face May Be Involved In The Procedure. |
| 61596-CPT | High | Surgery On Back Of The Brain, Surgery On The Back Portion Of The Brain To Remove A Lesion (Mass). The Procedure May Involve Bones Inside The Ear Or Sinuses As Well As Bones In The Spine (Vertebrae). Nerve Or Blood Vessels In The Face May Be Involved In The Procedure. |
| 61597-CPT | High | Transcondylar Approach Skull, Transcondylar Far Lateral Approach To Posterior Cranial Fossa Jugular Foramen Or Midline Skull Base Including Occipital Condylectomy Mastoidectomy Resection Of C1 C3 Vertebral Body S Decompression Of Vertebral Artery 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 61596. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61596 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61596) and we'll show you how you compare in 15 minutes or less.