CPT 61630 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 • LT - Left side of body • AG - Primary physician |
| Complexity Level | High |
National average reimbursement for CPT 61630 by major payers:
$1,787.21
$1,837.50
$1,872.36
$2,245.72
| 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 61630 | ||||||
United | 61630 | $1603.00 | 1972254233 - HACKENSACK MUSCULOSKELETAL SURGERY CENTER, LLC | 853437054 - (NJ) HACKENSACK MUSCULOSKELETAL SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $775.00 | 1952360059 - MAINE EYE CARE ASSOCIATES, MAINE EYE CARE SURGERY CENTER | 10316462 - (ME) EYE CARE OF MAINE, P.A. F/K/A MAINE EYE CARE, P.A. | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1262.00 | 1962031807 - CVP SURGERY CENTER IVY POINTE, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1274.00 | 1821429978 - EL MIRADOR SURGERY CENTER LLC, EL MIRADOR SURGERY CENTER | 300798280 - (CA) EL MIRADOR SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $725.00 | 1790269462 - BARBOUR ORTHOPAEDICS SURGERY CENTER, LLC | 822423698 - (GA) BARBOUR ORTHOPAEDICS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $293.00 | 1972658706 - FREDERICKTOWN AMBULATORY SURGICAL FACILITY, INC. | 521935764 - (MD) FREDERICKTOWN AMBULATORY SURGICAL FACILITY INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $109.00 | 1851516728 - PHOENIX ENDOSCOPY LLC | 710940187 - (AZ) PHOENIX ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $936.00 | 1255577045 - MAPLE LAWN SURGERY CENTER | 262739529 - (MD) MAPLE LAWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $335.00 | 1336100189 - ST MICHAELS SURGERY CENTER INC. | 593748609 - (FL) ST MICHAELS SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $4300.00 | 1467696815 - MORRIS COUNTY SURGICAL CENTER LLC | 263513595 - (NJ) MORRIS COUNTY SURGICAL CENTER, L.L.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $424.00 | 1235321571 - SURGICARE SURGICAL ASSOCIATES OF MAHWAH, LLC | 202811130 - (NJ) SURGICARE SURGICAL ASSOCIATES OF MAHWAH LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $687.00 | 1508845942 - ENDOSCOPY CENTER OF KNOXVILLE LP, THE ENDOSCOPY CENTER WEST | 621512837 - (TN) ENDOSCOPY CENTER OF KNOXVILLE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $565.00 | 1407004534 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $500.00 | 1114924651 - CARILION SURGERY CENTER NEW RIVER VALLEY, LLC, CARILION | 800091329 - (VA) CARILION SURGERY CENTER NEW RIVER VALLEY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1028.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | 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 61630 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61630 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 61630 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 |
| 61635-CPT | High | Transcatheter Placement Of Intravascular Stent Intracranial Including Balloon Angioplasty If Performed- Deny Inv/N10 8/12/2006-9/10/2011, Rn Review>=9/11/2011 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61630 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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