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See a sample rate comparisonHealthcare 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 11 - Office |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61798 |
| Medicaid Fee Schedule | View Medicaid rates for 61798 |
National average reimbursement for CPT 61798 by major payers:

$1,640.88

$1,727.85

$1,974.45

$2,127.47
Choose a payer to see a sample of rates for CPT 61798.
Gulfport Surgery Clinic, LLC
Surgical Specialty Center Of Westchester, LLC
Pennsylvania Surgery And Laser
American Access Care Of Miami Asc LLC
Heartland Cataract Laser Surgery Center Inc
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 61798 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61798 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 61798 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 | Surgical Radiation Therapy, Radiosurgery Delivers Radiation Therapy Directly Into The Skull. Stereotactic Imaging Is Used To Precisely Map The Target Location In Three Dimensions. |
| 61798-CPT | High | Surgical Radiation Therapy, Radiosurgery Delivers Radiation Therapy Directly Into The Skull. Stereotactic Imaging Is Used To Precisely Map The Target Location In Three Dimensions. |
| 61799-CPT | Moderate | Stereotactic Radiosurgery (Par, Stereotactic Radiosurgery (Particle Beam Gamma Ray Or Linear Accelerator) Each Additional Craniallesion Complex (List Separately In Addition To C Ode For Primary Procedure) |
| 61800-CPT | Low | Head Frame For Radiation, Attachment Of A Frame To The Head In Preparation For Surgical Radiation Treatment. The Frame Is Used For Stereotactic Imaging Which Precisely Maps A Target Location In Three Dimensions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61798. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61798 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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