CPT 61790 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 61790 by major payers:
$1,270.91
$1,183.24
$1,257.44
$1,446.95
| 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 61790 | ||||||
United | 61790 | $1405.00 | 1487096061 - ARETE SURGICAL CENTER, LLC | 455436298 - (CO) ARETE SURGICAL CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $873.00 | 1316969058 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $2353.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $1687.00 | 1629079058 - CARES SURGICENTER LLC | 223557777 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $675.96 | 1639331317 - OSAZE EDO-OHONBA | 350593390 - DEACONESS HOSPITAL INC | MO | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 61790 | $1708.00 | 1023297553 - PHYSICIANS SURGERY CENTER, LLC | 260425547 - (IL) PHYSICIANS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $2388.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $1419.00 | 1750386322 - NOVAMED SURGERY CENTER OF COLORADO SPRINGS, LLC, PREMIER SURGERY CENTER | 731630170 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $1960.00 | 1154400471 - ST. LOUIS WOMEN'S SURGERY CENTER, LLC, ST. LOUIS MULTISPECIALTY SURGERY CENTER | 680526281 - (MO) ST LOUIS WOMENS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $900.00 | 1316253438 - TREASURE COAST UROLOGY CENTER, LLC | 273328667 - (FL) TREASURE COAST UROLOGY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $2250.00 | 1972153997 - EASTERN PENNSYLVANIA ENDOSCOPY CENTER, LLC | 842257961 - (PA) EASTERN PENNSYLVANIA ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $1471.00 | 1386677326 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $672.00 | 1649376757 - ADS HEALTHCARE LLC, ADS AMBULATORY SURGERY CENTER | 481207671 - (KS) ADS HEALTHCARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $830.00 | 1760594279 - FILUTOWSKI EYE INSTITUTE PA, SUNRISE SURGICAL CENTER | 593111497 - (FL) FILUTOWSKI EYE INSTITUTE, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61790 | $3150.00 | 1649793613 - BAYLOR SURGICARE AT BLUE STAR, LLC | 812931756 - (TX) BAYLOR SURGICARE AT BLUE STAR LLC | TX | 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 61790 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61790 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 61790 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 |
| 61650-CPT | Moderate | Endovascular Intracranial Prolonged Administrationof Pharmacologic Agent(S) Other Than For Thrombolysis Arterial Including Catheter Placement Diagnostic Angiography And Imaging Guidance; Initial Vascular Territory. |
| 61790-CPT | High | Creation Of Lesion By Stereotactic Method, Percutaneous, By Neurolytic Agent (Eg, Alcohol, Thermal, Electrical, Radiofrequency); Gasserian Ganglion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61790. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61790 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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