CPT 61800 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 |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
National average reimbursement for CPT 61800 by major payers:
$198.16
$210.53
$229.22
$260.42
| 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 61800 | ||||||
United | 61800 | $373.00 | 1275071789 - KADLEC REGIONAL MEDICAL CENTER | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $300.00 | 1649250218 - LORAIN SURGERY CENTER, LLC | 201641777 - (OH) LORAIN SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $130.00 | 1588663512 - THOMAS EYE SURGERY CENTER LLC | 582464498 - (GA) THOMAS EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $59.00 | 1447599659 - SOUTHEAST EYE SURGERY CENTER, LLC | 455054338 - (TN) SOUTHEAST EYE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $1446.00 | 1487371431 - BAYLOR SCOTT & WHITE SURGICARE WAXAHACHIE LLC | 920758698 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $200.00 | 1730789231 - ZEO SURGICAL CENTER LLC, LENZA SURGICAL CENTER | 853310734 - (TX) ZEO SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $119.00 | 1225228547 - GULF COAST SURGICAL CENTER LLC | 203321032 - (LA) GULF COAST SURGICAL CENTER, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $263.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $1708.00 | 1629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP | 841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $857.00 | 1336154152 - A CENTER FOR FOOT AND ANKLE SURGERY PA, THE CENTER FOR SPECIAL SURGERY OF HAWTHORNE | 223284458 - (NJ) A CENTER FOR FOOT AND ANKLE SU | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $150.00 | 1083643852 - AMARILLO COLONOSCOPY CENTER LP, PANHANDLE ENDOSCOPY CENTER LP | 202528490 - (TX) AMARILLO COLONOSCOPY CENTER, LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $1708.00 | 1013136456 - SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC, ADVANCED SURGICAL INSTITUTE | 204481032 - (NJ) SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $274.00 | 1538122569 - CENTENNIAL SURGERY CENTER LP | 621624530 - (TN) CENTENNIAL SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $134.00 | 1730843830 - VOLUSIA ASC BZ, LLC, ADVANCED HEART AND VASCULAR SURGERY CENTER AT DELTONA | 851554243 - (FL) VOLUSIA ASC BZ, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61800 | $1543.00 | 1528479664 - HHC SOUTHINGTON SURGERY CENTER, LLC, CHESHIRE SURGERY CENTER | 465500829 - (CT) HHC SOUTHINGTON SURGERY CENTER, LLC | CT | 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 61800 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61800 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 61800 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) |
| 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) |
| 61800-CPT | Low | Application Of Stereotactic Headframe For Stereotactic Radiosurgery (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 61800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61800 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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