CPT 61613 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 • 23 - Emergency Room |
| Common Modifiers | • None • 62 - Co-Surgeons • 22 - Increased Procedural Services • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61613 |
National average reimbursement for CPT 61613 by major payers:
$4,434.79
$4,442.78
$4,546.45
$5,361.58
| 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 61613 | ||||||
United | 61613 | $475.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $5658.00 | 1013548833 - ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC, ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT | 843972619 - (WI) ASCENSION WISCONSIN SURGERY CENTERMOUNT PLEASANT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $523.00 | 1750420147 - INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER, ISPM ASC | 205896580 - (GA) INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $2575.00 | 1568906212 - HOUSTON UROLOGIC SURGICENTER, LLC | 814537533 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $2732.00 | 1093459315 - PERFORMANCE HEALTH SURGICENTER, LLC | 881897351 - (FL) PERFORMANCE HEALTH SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $477.00 | 1326107509 - OMAHA AMBULATORY SURGERY CENTER LLC | 205880863 | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $1049.00 | 1386657047 - THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CENTER, LLC | 20594510 - (TX) THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CTR, LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $862.00 | 1083686208 - WICHITA ORTHOPAEDIC ASC LLC, SURGERY CENTER OF KANSAS | 621659908 - (KS) WICHITA ORTHOPAEDIC ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $1650.00 | 1275071789 - KADLEC REGIONAL MEDICAL CENTER | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $171.00 | 1588777130 - J J YOUNG MD, THE CATARACT CENTER OF LAWTON | 731221077 - (OK) J J YOUNG MD | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $6314.00 | 1649482449 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $6500.00 | 1437459617 - UNION HEALTH SERVICES, LLC, ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL | 300597871 - (NC) UNION HEALTH SERVICES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $461.00 | 1164478764 - SURGERY CENTER OF LAWTON PROFESSIONAL LLC | 731579076 - (OK) SURGERY CENTER OF LAWTON PROFESSIONAL LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $352.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61613 | $410.00 | 1619291192 - DALLAS IVF SURGERY CENTER, LLC, DALLAS IVF SURGERY CENTER | 263473774 - (TX) DALLAS IVF 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 61613 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61613 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 61613 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 |
| 61623-CPT | Moderate | Endovascular Temporary Balloon Arterial Occlusion Head Or Neck (Extracranial/Intracranial) Including Selective Catheterization Of Vessel To Be Occlu Ded Positioning And Inflation Of Occlusion Ballo On Concomitant Neurological Monitoring And Radiologic Supervision And Interpretation Of All Angiography Required For Balloon Occlusion And To Exclude Vascular Injury Post Occlusion |
| 61630-CPT | High | Balloon Angioplasty Intracranial Percutaneous |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61613 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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