CPT 61720 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • AG - Primary physician • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61720 |
National average reimbursement for CPT 61720 by major payers:
$1,745.04
$1,711.24
$1,749.05
$2,087.28
| 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 61720 | ||||||
United | 61720 | $5433.00 | 1700887643 - MNH SURGICAL CENTER INC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $7175.00 | 1871033878 - REDMOND AMBULATORY SURGERY CENTER, LLC | 813558711 - (WA) REDMOND AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $5200.00 | 1033714001 - SURGERY CENTER AT SOUTH OGDEN, LLC | 854070407 - (UT) SURGERY CENTER AT SOUTH OGDEN LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $2693.00 | 1053560896 - ASC DEVELOPMENT COMPANY, LLC, NATIONAL SPINE AND PAIN CENTERS | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $2709.00 | 1881134815 - PORT JEFFERSON ASC, LLC | 371794376 - (NY) PORT JEFFERSON ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $1130.00 | 1114312659 - UNITED SHOCKWAVE SERVICES, LTD., UNITED THERAPIES | 363415474 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $2931.00 | 1144370594 - THIRD STREET SURGERY CENTER LLC, THIRD STREET SURGERY CENTER LP | 841663840 - (CA) THIRD STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $2899.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $1753.00 | 1548582463 - CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER, LLC, NONE | 271867311 - (VA) CAREPLEX ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $16929.00 | 1730212879 - TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $1543.00 | 1396771036 - THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | 30426509 - (VA) THE GASTROENTEROLOGY CENTER OF VIRGINIA, PLLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $1236.00 | 1982074001 - CLINICAL ASSOCIATES P A, CLINICAL ASSOCIATES, ASC | 465765243 - (MD) CLINICAL ASSOCIATES, P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $2640.00 | 1922335900 - PALMETTO LAKES SURGICAL CENTER, LLC | 943459481 - (FL) PALMETTO LAKES SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $5400.00 | 1144312075 - GATEWAY AMBULATORY SURGERY CENTER LLC, GATEWAY SURGERY CENTER | 202106989 - (NC) GATEWAY AMBULATORY SURGERY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61720 | $4200.00 | 1679913552 - SPINE SPORTS SURGERY CENTER, LLC, SPINE AND SPORTS SURGERY CENTER | 461141188 | CA | 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 61720 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61720 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 61720 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 |
|---|---|---|
| 61720-CPT | High | Creation Of Lesion By Stereotactic Method, Including Burr Hole(S) And Localizing And Recording Techniques, Single Or Multiple Stages; Globus Pallidus Or Thalamus |
| 61735-CPT | High | Creation Of Lesion By Stereotactic Method, Including Burr Hole(S) And Localizing And Recording Techniques, Single Or Multiple Stages; Subcortical Structure(S) Other Than Globus Pallidus Or Thalamus |
| 61736-CPT | High | Laser Interstitial Thermal Therapy (Litt) Of Lesion Intracranial Including Burr Hole(S) Withmagnetic Resonance Imaging Guidance When Performed; Single Trajectory For 1 Simple Lesion |
| 61737-CPT | High | Laser Interstitial Thermal Therapy (Litt) Of Lesion Intracranial Including Burr Hole(S) Withmagnetic Resonance Imaging Guidance When Performed; Multiple Trajectories For Multiple Or Complex Lesion(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61720 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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