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See a sample rate comparisonCPT 61690 Fee Schedule
Last Verified: October 2026
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.
Surg.Intracr.Art.Malform;Dural,Smpl
| 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 AS - PA/NP/CNS assistant at surgery 52 - Reduced Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61690 |
| Medicaid Fee Schedule | View Medicaid rates for 61690 |
National average reimbursement for CPT 61690 by major payers:
$2,925.12
$2,976.19
$3,001.74
$3,492.13
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CPT 61690
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, Saxony Surgery Center
$7,400.00Published rateAtherton Plastic Surgery Center
$1,274.00Published ratePhysicians Eye Surgery Center LLC, Physicians' Eye Surgery Center
Physicians Eye Surgery Center
$746.00Published rateUsc, LLC, Unasource Surgery Center
Usc, LLC
$439.00Published rateMeah Asc Management, LLC
Meah Asc Management LLC
$129.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 61690 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61690 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 61690 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 |
|---|---|---|
| 61684-CPT | High | Surg Of Ntracrani Arterioveno Malform; Nfrtentorial, Surgery Of Intracranial Arteriovenous Malformation; Infratentorial Si |
| 61686-CPT | High | Surg Of Ntracrani Arterioveno Malform; Nfrtentorial, Surgery Of Intracranial Arteriovenous Malformation; Infratentorial Co |
| 61690-CPT | High | Surg.Intracr.Art.Malform;Dural,Smpl |
| 61692-CPT | High | Rep Av Lesion Dural-Complex |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61690. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61690 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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