CPT 61799 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 61799 |
National average reimbursement for CPT 61799 by major payers:
$372.56
$417.40
$468.83
$505.07
| 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 61799 | ||||||
United | 61799 | $1200.00 | 1649350844 - NORTHERN PLAINS SURGERY CENTER LLC | 450447247 - (ND) NORTHERN PLAINS SURGERY CENTER, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $2409.00 | 1649931072 - MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS, LLC, MEDICAL CITY ORTHOPEDIC & SPINE SURGERY CENTER DALLAS | 842824507 - (TX) MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $734.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $850.00 | 1134779622 - HELIX SURGICENTER LLC | 834455797 - (IN) HELIX SURGICENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $1233.00 | 1184687386 - DIGESTIVECARE, LLC, DIGESTIVECARE ENDOSCOPY UNIT | 311108485 - (OH) DIGESTIVE CARE, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $323.00 | 1487779435 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER | 521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $865.00 | 1386650778 - NORTH BEND MEDICAL CENTER INC, NBMC-DAY SURGERY | 371843700 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $916.00 | 1689755894 - SKIN SURGERY CENTER PS, SKIN SURGERY CENTER | 911954101 - (WA) SKIN SURGERY CENTER P. S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $496.00 | 1922144484 - INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | 202908826 - (MO) INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $539.00 | 1609568922 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $994.00 | 1437597812 - VIVERE HEALTH AUSTIN, LLC, VIVERE AUSTIN SURGERY CENTER | 611694454 - (TX) VIVERE HEALTH AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $734.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $1245.00 | 1619519535 - ANDERSON SURGERY CENTER LLC | 834200085 - (IL) ANDERSON SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $300.00 | 1306964853 - GASTROENTEROLOGY ENDOSCOPY CENTER | 582349040 - (GA) GASTROENTEROLOGY ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61799 | $1300.00 | 1609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON | 270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC | NJ | 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 61799 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61799 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 61799 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 61799. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61799 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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