CPT 61797 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 11 - Office |
| Common Modifiers | • None • GZ - Item or Service Expected to Be Denied as Not Reasonable and Necessary • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
National average reimbursement for CPT 61797 by major payers:
$274.61
$302.09
$341.92
$368.91
| 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 61797 | ||||||
United | 61797 | $365.00 | 1790822864 - NORTHWEST EYE SPECIALISTS,LLC | 860720868 - (AZ) NORTHWEST EYE SPECIALISTS, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $700.00 | 1932132065 - AMBULATORY SURGICAL CTR OF AIKEN LLC, THE SURGERY CENTER OF AIKEN | 830879278 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $695.00 | 1922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC | 640897321 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $721.00 | 1437221660 - ENDOSCOPY CENTER, CAROLINA ENDOSCOPY CENTER- UNIVERSITY | 260317003 - (NC) ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $1276.00 | 1811385883 - CENTRAL DELAWARE ENDOSCOPY UNIT LLC | 471840129 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $794.00 | 1609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC | 873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $1258.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $2483.00 | 1114435856 - EINSTEIN MEDICAL CENTER MONTGOMERY, EINSTEIN ENDOSCOPY CENTER - BLUE BELL | 204193243 - (PA) ALBERT EINSTEIN HEALTHCARE NETWORK | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $2480.00 | 1376790691 - MEMORIAL HERMANN ENDOSCOPY & SURGERY CENTER NORTH HOUSTON, LLC, NORTH HOUSTON ENDOSCOPY & SURGERY CENTER | 262809136 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $650.00 | 1104868561 - REGIONAL SURGERY CENTER, P.C. | 431527254 - (MO) REGIONAL SURGERY CENTER PC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $336.00 | 1396870028 - BRAZOSPORT EYE FACILITY, INC., BRAZOSPORT EYE INSTITUTE | 760106449 - (TX) BRAZOSPORT EYE FACILITY INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $361.00 | 1073579256 - OUTPATIENT SURGICAL CARE LTD | 860525610 - (AZ) OUTPATIENT SURGICAL CARE LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $1887.00 | 1922365808 - GWINNETT ADVANCED SURGERY CENTER, LLC | 455067682 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $947.00 | 1881113785 - BANNER ESTRELLA SURGERY CENTER LLC | 901183954 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61797 | $362.00 | 1942353115 - SOUTHERN CRESCENT PLASTIC SURGERY ASC | 582093063 | GA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 61797 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61797 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 61797 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 |
|---|---|---|
| 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 |
| 61799-CPT | Moderate | Stereotactic Radiosurgery (Particle Beam, Gamma Ray, Or Linear Accelerator); Each Additional Cranial Lesion, Complex (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61797. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61797 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61797) and we'll show you how you compare in 15 minutes or less.