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CPT 61686 Fee Schedule

Last Verified: November 2025

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.

Rep Av Lesion Infratent-Complex
Key FactDetail
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

AS - PA/NP/CNS assistant at surgery

Complexity LevelHigh

National average reimbursement for CPT 61686 by major payers:

bcbs

$6,150.21

uhc

$6,269.50

aetna

$6,360.06

cigna

$7,374.24

Preview provider-level rates for...
For billing codeCPT 61686
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 61686

United
61686$570.001891770814 - REGIONAL HAND CENTER OF CENTRAL CALIFORNIA, INC770521088CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$250.001700921251 - ELTRA LLC810598060 - (NJ) ELTRA LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1042.001932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER223777533 - (NJ) MAY STREET SURGI CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$415.001679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER812203868FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1000.001164723011 - SURGICAL SPECIALTY CENTER OF WESTCHESTER LLC, PLASTIC SURGERY CENTER OF WESTCHESTER LLC273453889 - (NY) SURGICAL SPECIALTY CENTER OF WESTCHESTER, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1028.001881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER454068750FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$398.001821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER205904604LAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1367.001194727883 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE PUGET SOUND SURGERY CENTER911606533 - (WA) PROLIANCE SURGEONS, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1028.001265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGIFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1000.001194264036 - ADVANCED SURGICAL CENTER, LLC475144859 - (TX) ADVANCED SURGICAL CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$1274.001518356070 - DIGESTIVE DISEASE CENTER OF AMARILLO LLC752893120 - (TX) AMARILLO ENDOSCOPY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$5554.001407165772 - MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY, LLC, MEMORIAL HERMANN SURGERY CENTER WOODLANDS PARKWAY273520409TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$2040.001285980151 - PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN, LLC, GOOD SAMARITAN SURGERY CENTER270573717 - (IL) PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$283.001275513806 - PINNACLE CATARACT AND LASER INSTITUTE LLC743117000 - (WI) PINNACLE CATARACT AND LASER INSTITUTE LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
61686$658.001346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP593346125 - (FL) LAKELAND SURGICAL AND DIAGNOSTIC CENTER LLPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 61686 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 61686 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 61686 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.

CodeComplexityDescription
61680-CPTHighSurg.Intracr Arter.Malform;Supr,Smp
61682-CPTHighRep Av Lesion Supratent-Complex
61684-CPTHighSurg.Intracr.Art.Malform;Infrat,Smp
61686-CPTHighRep Av Lesion Infratent-Complex

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61686. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 61686 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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