CPT 61611 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 82 - Assistant surgeon - no qualified resident • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 61611 by major payers:
$561.31
$626.86
$617.84
$741.85
| 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 61611 | ||||||
United | 61611 | $800.00 | 1629045133 - MONTICELLO COMMUNITY SURGERY CENTER, LLC, UVA HEALTH SURGICAL CARE RIVERSIDE | 113656095 - (VA) MONTICELLO COMMUNITY SURGERY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $906.00 | 1659574283 - PROVIDENCE VENTURES, LLC, BONE AND JOINT SURGERY CENTER OF NOVI | 161704029 - (MI) PROVIDENCE VENTURES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $575.00 | 1023151974 - DEL MAR SURGERY CENTER | 330869192 - (CA) DEL MAR SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $1049.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $1077.00 | 1417287137 - EAST PORTLAND SURGERY CENTER LLC | 271402985 - (OR) EAST PORTLAND SURGERY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $550.00 | 1255746087 - OSI, LLC | 352509822 - (MI) OSI, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $2732.00 | 1083873277 - VENTURE AMBULATORY SURGERY CENTER LLC | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $415.00 | 1639237092 - MUSCULOSKELETAL AMBULATORY SURGERY CENTER INC, THE SURGERY CENTER AT POINTE WEST | 650829385 - (FL) MUSCULOSKELETAL AMBULATORY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $402.00 | 1356490817 - CHRISTUS CABRINI SURGERY CENTER, LLC, CHRISTUS CABRINI SURGERY CENTER | 204705651 - CHRISTUS CABRINI SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $1310.00 | 1912909169 - KIPS BAY ENDOSCOPY CENTER, LLC | 134243635 - (NY) KIPS BAY ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $1049.00 | 1235178146 - SUBURBAN ENDOSCOPY CENTER, LLC, SUBURBAN ENDOSCOPY CENTER | 820556996 - (NJ) SUBURBAN ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $721.00 | 1750974176 - NCBH OUTPATIENT ENDOSCOPY CENTER, L.L.C., WAKE FOREST BAPTIST HEALTH OUTPATIENT ENDOSCOPY - QUAKER LANE | 270668137 - (NC) NCBH OUTPATIENT ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $561.00 | 1255070116 - MERCY SOUTH ASC LLC, MERCY OUTPATIENT SURGERY CENTER - WEST BEND | 882512783 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $661.00 | 1336254770 - EYE SURGERY CENTER OF THE DESERT | 330708059 - (CA) EYE SURGERY CENTER OF THE DESERT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61611 | $520.00 | 1275542011 - NORTH CRESCENT SURGERY CENTER, L.L.C. | 201764601 - (GA) NORTH CRESCENT SURGERY CENTER LLC | GA | 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 61611 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61611 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 61611 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 |
|---|---|---|
| 61611-CPT | Moderate | Transection Or Ligation, Carotid Artery In Petrous Canal; Without Repair (List Separately In Addition To Code For Primary Procedure) |
| 61613-CPT | High | Obliteration Of Carotid Aneurysm, Arteriovenous Malformation, Or Carotid-Cavernous Fistula By Dissection Within Cavernous Sinus |
| 61630-CPT | High | Balloon Angioplasty Intracranial Percutaneous |
| 61645-CPT | High | Percutaneous Arterial Transluminal Mechanical Thrombectomy And/Or Infusion For Thrombolysis Intracranial Any Method Including Diagnostic Angiography Fluoroscopic Guidance Catheter Placement And Intraprocedural Pharmacological Thrombolytic Injection(S). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61611. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61611 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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