CPT 61605 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 • 51 - Multiple procedures • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61605 |
National average reimbursement for CPT 61605 by major payers:
$2,651.83
$2,955.32
$3,174.96
$3,654.07
| 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 61605 | ||||||
United | 61605 | $1899.00 | 1881789964 - NEW LEXINGTON CLINIC, PSC, LEXINGTON CLINIC AMBULATORY SURGERY CENTER | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $969.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $1064.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $1028.00 | 1902807159 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $575.00 | 1962661884 - ACD-SA, LTD., SENDERO IMAGING AND TREATMENT CENTER | 742822681 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $250.00 | 1427003904 - PHILADELPHIA WOMEN'S CENTER, INC. | 232476628 - (PA) PHILADELPHIA WOMENS CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $1955.00 | 1336459353 - LONE STAR ENDOSCOPY CENTER LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $525.00 | 1487158796 - CENTRIC AMBULATORY SURGERY CENTER LLC | 824465250 - (MO) CENTRIC AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $112.00 | 1669540118 - STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC, VALLEY LASER SURGERY CENTER, INC. | 203111961 - (CA) STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $107.00 | 1750658092 - ADVANCED CENTER FOR SURGERY, LLC | 273049891 - (PA) ADVANCED CENTER FOR SURGERY, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $732.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $352.00 | 1821093204 - LAUREL LASER & SURGERY CENTER, L.P. | 251852464 - (PA) LAUREL LASER SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $587.00 | 1376692129 - STUART CARDON, CASCADE FOOT AND ANKLE PLLC | 205179809 - (WA) STUART CARDON DBA CASCADE FOOT & | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $1954.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61605 | $1000.00 | 1457385668 - RAVINE WAY SURGERY CENTER, LLC | 201245279 - (IL) RAVINE WAY SURGERY CENTER, LLC | IL | 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 61605 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61605 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 61605 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 |
|---|---|---|
| 61600-CPT | High | Resect/Excisn Neopl, Vasc Or Infect Lesn Ant Cranial Fossa; Extradural |
| 61601-CPT | High | Resection Or Excision Of Neoplastic, Vascular Or Infectious Lesion Of Base Of Anterior Cranial Fossa; Intradural, Including Dural Repair, With Or Without Graft |
| 61605-CPT | High | Resection Or Excision Of Neoplastic, Vascular Or Infectious Lesion Of Infratemporal Fossa, Parapharyngeal Space, Petrous Apex; Extradural |
| 61606-CPT | High | Resection Or Excision Of Neoplastic, Vascular Or Infectious Lesion Of Infratemporal Fossa, Parapharyngeal Space, Petrous Apex; Intradural, Including Dural Repair, With Or Without Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61605 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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