CPT 61597 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61597 |
National average reimbursement for CPT 61597 by major payers:
$4,027.68
$3,972.03
$4,229.77
$4,830.29
| 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 61597 | ||||||
United | 61597 | $501.00 | 1083780662 - PLASTIC SURGICENTRE, INC, THE PLASTIC SURGICENTRE, INC | 911473281 - (WA) THE PLASTIC SURGICENTRE, INC. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $509.00 | 1437274495 - EYE SURGICAL CENTER OF SAN FRANCISCO LLC, EYE SURGERY CENTER OF SAN FRANCISCO | 203822864 - (CA) EYE SURGERY CENTER OF SAN FRANCISCO | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $1344.00 | 1831275775 - NORTH JERSEY GASTROENTEROLOGY & ENDOSCOPY CENTER P.A. | 223637494 - (NJ) NORTH JERSEY GASTROENTEROLOGY ENDOSCOPY CENTER PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $2575.00 | 1083776314 - CROZER-CHESTER MEDICAL CENTER | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $900.00 | 1588119283 - DOCTORS OUTPATIENT SURGERY CENTER LLC, DOCTORS OUTPATIENT SURGERY CENTER | 364835603 - (NE) DOCTORS OUTPATIENT SURGERY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $1023.00 | 1770869927 - SYRACUSE SURGERY CENTER, LLC | 453629322 - (NY) SYRACUSE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $2732.00 | 1275596314 - JOHNSON COUNTY SURGERY CENTER, L.P. | 342029776 - (KS) JOHNSON COUNTY SURGERY CENTER LP | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $2302.00 | 1063598597 - CLEAR CREEK SURGERY CENTER LLC | 200871085 - (CO) CLEAR CREEK SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $2732.00 | 1427012202 - OUTPATIENT SURGICAL SERVICES LTD | 752433596 - (FL) OUTPATIENT SURGICAL SERVICES LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $1416.00 | 1619979580 - PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER PORT ORANGE | 201388947 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $483.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $291.00 | 1184600736 - MERIDIAN SURGERY CENTER, LLC | 300160065 - (MS) MERIDIAN SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $419.00 | 1417903899 - JUPITER OUTPATIENT SURGERY CENTER LLC | 650925020 - (FL) JUPITER OUTPATIENT SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $995.00 | 1538608138 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61597 | $610.00 | 1659594190 - PSA AMBULATORY SURGICAL CENTER OF AUSTIN LLC | 205913499 - (TX) PSA AMBULATORY SURGICAL CENTER OF AUSTIN 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 61597 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61597 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 61597 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 |
|---|---|---|
| 61591-CPT | High | Infratemporal Post-Auricular Approach To Middle Cranial Fossa (Internal Auditory Meatus Petrous Apex Tentorium Cavernous Sinus Parasellar Area Infratemporal Fossa) Including Mastoidectomy Resection Of Sigmoid Sinus With Or Without Decompression And/Or Mobilization Of Contents Of Auditory Canal 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 |
| 61596-CPT | High | Transcochlear Approach To Posterior Cranial Fossa, Jugular Foramen Or Midline Skull Base, Including Labyrinthectomy, Decompression, With Or Without Mobilization Of Facial Nerve And/Or Petrous Carotid Artery |
| 61597-CPT | High | 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 61597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61597 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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