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 |
| Medicare Fee Schedule | View Medicare rates for 61630 |
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 | $419.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1085.00 | 1609977610 - UOC SURGICAL SERVICES, LTD. | 251890694 - (PA) UOC SURGICAL SERVICES LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1040.00 | 1639252760 - POST STREET SURGERY CENTER, LLC | 943397049 - (CA) POST STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $604.00 | 1881147965 - ULNA SURGERY CENTER LLC | 813050347 - (GA) ULNA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $2650.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $350.00 | 1871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | 812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $11727.00 | 1396901542 - TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | 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 | $969.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $523.00 | 1356672919 - CPMSC ROSWELL, LLC | 271697405 - (GA) CPMSC ROSWELL LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $1064.00 | 1942507488 - GA ENDOSCOPY CENTER, LLC | 273115800 - (GA) GA ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $6489.00 | 1184601098 - FRANCISCAN SURGERY CENTER, LLC | 352128334 - (IN) FRANCISCAN SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $2652.00 | 1144970807 - MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC | 881391141 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $469.00 | 1386858595 - ALDERWOOD SURGERY CENTER LLC | 204979154 - (WA) ALDERWOOD SURGICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61630 | $2500.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | 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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