CPT 61860 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61860 |
National average reimbursement for CPT 61860 by major payers:
$1,976.59
$2,124.46
$2,169.37
$2,561.13
| 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 61860 | ||||||
United | 61860 | $936.00 | 1962714154 - SURGCENTER OF WHITE MARSH, LLC | 272873637 - (MD) SURGCENTER OF WHITE MARSH, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $817.00 | 1083711568 - NATRAJ SURGERY CENTER INC. | 201290128 - (CA) NATRAJ SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $1028.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $531.00 | 1629166624 - AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | 861081788 - (NV) AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $773.00 | 1871257071 - SOUTHDALE SPECIALTY SURGERY CENTER, LLC, BHATTI GI CONSULTANTS, P.A. | 873212683 - (MN) SOUTHDALE SPECIALTY SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $2280.00 | 1215930078 - MARIN HEALTH VENTURES, LLC, MARIN SPECIALTY SURGERY CENTER | 943377073 - (CA) MARIN HEALTH VENTURES, INC. DBA MARIN SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $480.00 | 1588785208 - AMBER MEADOWS SURGERY CENTER LLC | 208756114 - (MD) AMBER MEADOWS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $775.00 | 1508342114 - ACTD,LLC, GREEN MOUNTAIN SURGERY CENTER | 472161109 - (VT) ACTDLLC | VT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $150.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $1064.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $425.00 | 1932657335 - VOLUSIA ORTHOPAEDIC TRAUMA CALL ASSOCIATES LLC, EAST COAST SURGERY CENTER | 300950557 - (FL) VOLUSIA ORTHOPAEDIC TRAUMA CALL ASSOCIATES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $1274.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $398.00 | 1033426580 - ADVANCED AMBULATORY SURGERY CENTER, LLC | 271607092 - (IN) ADVANCED AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $2040.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61860 | $640.00 | 1386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC | 352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLC | IN | 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 61860 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61860 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 61860 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 |
|---|---|---|
| 61850-CPT | High | Twst Drl/Brr Hole-Impl Elec;Corticl |
| 61860-CPT | High | Craniec/Otmy Impln-Elec,Cerebr;Cort |
| 61863-CPT | High | Twist Drill Burr Hole Craniotomy Or Craniectomy With Stereotactic Implantation Of Neurostimulator Electrode Array In Subcortical Site (Eg Thalamus Globus Pallidus Subthalamic Nucleus Periventricular Periaqueductal Gray) Without Use Of Intraoperative Microelectrode Recording; First Array |
| 61864-CPT | Moderate | Twist Drill Burr Hole Craniotomy Or Craniectomy With Stereotactic Implantation Of Neurostimulator Electrode Array In Subcortical Site (Eg Thalamus Globus Pallidus Subthalamic Nucleus Periventricular Periaqueductal Gray) Without Use Of Intraoperative Microelectrode Recording; Each Additional Array (List Separately In Addition To 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 61860. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61860 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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