CPT 61798 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 • 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 |
National average reimbursement for CPT 61798 by major payers:
$1,640.88
$1,727.85
$1,974.45
$2,185.29
| 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 61798 | ||||||
United | 61798 | $1691.00 | 1821098443 - HAZLETON AMBULATORY SURGICAL CENTER LLC | 232971919 - (PA) HAZLETON AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $5484.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $3000.00 | 1790237501 - AMERICAN ACCESS CARE OF SP ASC LLC | 814086575 - (PA) AMERICAN ACCESS CARE OF SP ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $3327.00 | 1619979580 - PORT ORANGE ENDOSCOPY & SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER PORT ORANGE | 201388947 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $4134.00 | 1780618801 - PINEY ORCHARD SURGERY CENTER, LLC. | 521938770 - (MD) PINEY ORCHARD SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $3223.00 | 1013522127 - SARC BY HSH ASC PINE BLUFF, LLC, SARC BY HSH ASC PINE BLUFF LLC | 850884465 - (AR) SARC BY HSH ASC PINE BLUFF LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $6588.00 | 1427152073 - PATIENT PARTNERS LLC | 201400198 - (TN) PATIENT PARTNERS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $3584.00 | 1154787117 - THE PENNSYLVANIA SURGERY AND LASER CENTER LLC | 300826026 - (PA) PENNSYLVANIA SURGERY AND LASER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $1631.00 | 1780767673 - EYE CARE SURGERY CENTER OF SOUTHAVEN,LLC | 30527649 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $4072.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $1508.00 | 1437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER | 470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $2800.00 | 1710420120 - AMERICAN ACCESS CARE OF MIAMI ASC LLC, AZURA SURGERY CENTER MIAMI | 814118495 - (FL) AMERICAN ACCESS CARE OF MIAMI ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $3800.00 | 1619557519 - SCOTTSDALE MULTISPECIALTY SURGERY CENTER, PARADISE VALLEY MULTI SPECIALTY SURGERY CENTER | 833515797 - (AZ) SCOTTSDALE MULTISPECIALTY SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $2992.00 | 1366422370 - URLOGY AMBULATORY SURGERY CENTER LLC, WOLF RIVER SURGERY CENTER | 621828958 - (TN) URLOGY AMBULATORY SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61798 | $1980.00 | 1831283860 - THE COOKEVILLE SURGERY CENTER | 621366678 - (TN) THE COOKEVILLE SURGERY CENTER | TN | 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 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 | 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 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 61798) and we'll show you how you compare in 15 minutes or less.