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See a sample rate comparisonHealthcare 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 GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61626 |
| Medicaid Fee Schedule | View Medicaid rates for 61626 |
National average reimbursement for CPT 61626 by major payers:

$1,164.84

$1,218.87

$1,332.21

$1,439.68
Choose a payer to see a sample of rates for CPT 61626.
Childrens Hospital
St Joseph Hospital
Columbia University In The City Of New York
Town Center Orthopaedic Associates, P.C.
Deaconess Hospital Inc
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 61626 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61626 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 61626 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 |
|---|---|---|
| 61623-CPT | Moderate | Endovasc Tempory Vessel Occl, Endovascular Temporary Balloon Arterial Occlusion Head Or Neck Extracranial Intracranial Including Selective Catheterization Of Vessel To Be Occluded Positioning And Inflation Of Occlusion Balloon Concomitant Neurological Monitoring And Radiologic Supervision And Interpretation Of All Angiography Required For Balloon Occlusion And To Exclude Vascular Injury Post Occlusion |
| 61624-CPT | High | Tcat Perm Occls/Embolj Cns, Transcatheter Permanent Occlusion Or Embolization (Eg For Tumor Destruction To Achieve Hemostasis To Occlude A Vascular Malformation) Including All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention Percutaneous Any Method; Central Nervous System (Intracranial Spinal Cord) |
| 61626-CPT | High | Tcat Perm Occls Embol Noncns, Transcatheter Permanent Occlusion Or Embolization (Eg For Tumor Destruction To Achieve Hemostasis To Occlude A Vascular Malformation) Including All Radiological Supervision And Interpretation Intraprocedural Roadmapping And Imaging Guidance Necessary To Complete The Intervention Percutaneous Any Method Non-Central Nervous System Head Or Neck (Extracranial Brachiocephalic Branch) |
| 61645-CPT | High | Perq Art M Thrombect Nfs, 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 61626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61626 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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