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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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61635 |
| Medicaid Fee Schedule | View Medicaid rates for 61635 |
National average reimbursement for CPT 61635 by major payers:

$2,004.19

$1,972.67

$2,034.90

$2,362.93
Choose a payer to see a sample of rates for CPT 61635.
Shore Ambulatory Surgical Center LLC
The Corvallis Clinic, P.C.
Surgicare Associates LLC
Conway Cardiovascular Surgery Center LLC
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Rate Benchmarking
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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 61635 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61635 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 61635 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 |
|---|---|---|
| 61630-CPT | High | Balloon Angioplast Ntracrani(Eg Atherosclerotic Stenosis) Perc, Balloon Angioplasty Intracranial (Eg Atherosclerotic Stenosis) Perc |
| 61635-CPT | High | Intracran Angioplsty W Stent, Transcatheter Placement Of Intravascular Stent S Intracranial Eg Atherosclerotic Stenosis Including Balloon Angioplasty If Performed |
| 61640-CPT | Moderate | Balloon Dilatation Of Ntracran Vasospsm Percutane; Initial Ve, Balloon Dilatation Of Intracranial Vasospasm Percutaneous; Initial Ve |
| 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 61635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61635 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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