CPT 61796 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 • 58 - Staged or related procedure during postoperative period • 79 - Unrelated procedure - postop period |
| Complexity Level | High |
National average reimbursement for CPT 61796 by major payers:
$1,237.26
$1,329.90
$1,539.25
$1,658.36
| 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 61796 | ||||||
United | 61796 | $2172.00 | 1497728984 - MOUNT DORA OPHTHALMOLOGY ASC LLC, MID FLORIDA SURGERY CENTER | 621795778 - (FL) MOUNT DORA OPHTHALMOLOGY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $1094.00 | 1235285628 - DAYTON EYE SURGERY CENTER L.L.C., DAYTON EYE SURGERY CENTER | 311596557 - (OH) DAYTON EYE SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $4236.00 | 1588628358 - OKLAHOMA OUTPATIENT SURGERY LIMITED PARTNERSHIP | 731295678 - (OK) OKLAHOMA OUTPATIENT SURGERY LIMITED PARTNERSHIP | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $5709.00 | 1114435856 - EINSTEIN MEDICAL CENTER MONTGOMERY, EINSTEIN ENDOSCOPY CENTER - BLUE BELL | 204193243 - (PA) ALBERT EINSTEIN HEALTHCARE NETWORK | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $1499.00 | 1295713568 - HUTCHINSON AMBULATORY SURGERY CENTER, LLC | 481243738 - (KS) HUTCHINSON AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $7888.00 | 1083938765 - MEDICAL PARK TOWER SURGERY CENTER, LLC, MEDICAL PARK TOWER SURGERY CENTER | 270543475 - (TX) MEDICAL PARK TOWER SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $1064.00 | 1700828423 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $3836.00 | 1447347166 - UROLOGY SURGERY CENTER OF COLORADO LLC | 203146770 - (CO) UROLOGY SURGERY CENTER OF COLORADO LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $1692.94 | 1407866866 - CHRISTINE SCHAFFER | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 61796 | $5174.00 | 1790320612 - GS CAMPUS ASC, LLC, LAFAYETTE SURGERY CENTER | 821536566 - (CO) GS CAMPUS ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $4072.00 | 1073758298 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH ENDOSCOPY CENTER AT GALLOWAY NORTH | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $1692.94 | 1376982371 - PHILLIP ADAMS | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 61796 | $3844.00 | 1730601865 - SNAPFINGER VASCULAR ACCESS CENTER ASC LLC | 821940644 - (GA) SNAPFINGER VASCULAR ACCESS CENTER ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $6588.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61796 | $2969.00 | 1710081443 - VENTURA ENDOSCOPY CENTER LLC | 680543503 - (CA) VENTURA ENDOSCOPY CENTER LLC | 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 61796 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61796 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 61796 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 |
|---|---|---|
| 61791-CPT | High | Creation Of Lesion By Stereotactic Method, Percutaneous, By Neurolytic Agent (Eg, Alcohol, Thermal, Electrical, Radiofrequency); Trigeminal Medullary Tract |
| 61796-CPT | High | Once Per Dos Stereotactic Radiosurgery (Particle Beam, Gamma Ray, Or Linear Accelerator); 1 Simple Cranial Lesion- Rn Review |
| 61797-CPT | Moderate | Stereotactic Radiosurgery (Particle Beam, Gamma Ray, Or Linear Accelerator); Each Additional Cranial Lesion, Simple (List Separately In Addition To Code For Primary Procedure) |
| 61798-CPT | High | 1 Complex Cranial Lesion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61796. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61796 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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