CPT 61867 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61867 |
National average reimbursement for CPT 61867 by major payers:
$2,908.42
$3,089.37
$3,287.75
$3,734.88
| 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 61867 | ||||||
United | 61867 | $1335.00 | 1881612042 - THE HAND AND UPPER EXTREMITY SURGERY CENTER OF GEORGIA, LLC | 200147862 - (GA) THE HAND AND UPPER EXTREMITY SURGERY CENTER OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1887.00 | 1922365808 - GWINNETT ADVANCED SURGERY CENTER, LLC | 455067682 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1064.00 | 1558794081 - SURGERY CENTER OF SCOTTSDALE, LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $2164.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1215.00 | 1780613521 - LITCHFIELD HILLS SURGERY CENTER | 562441789 - (CT) LITCHFIELD HILLS SURGERY CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $369.00 | 1578515995 - RAND SURGICAL PAVILLION CORP | 650156637 - (FL) RAND SURGICAL PAVILLION CORP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1232.00 | 1104858513 - DOCTORS OUTPATIENT SURGERY CENTER LLC, SURGERY CENTER | 721341061 - (LA) DOCTORS OUTPATIENT SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1150.00 | 1902805278 - EAST METRO ASC LLC, HIGH POINTE SURGERY CENTER | 411890436 - (MN) HIGH POINTE SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $742.00 | 1336107580 - POMERADO OUTPATIENT SURGICAL CENTER L P, PALOMAR SURGICAL CENTER ESCONDIDO | 330752699 - (CA) POMERADO OUTPATIENT SURGICAL CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $477.00 | 1124526306 - INDIANA PAIN CENTERS-EVANSVILLE LLC | 823643604 - (IN) INDIANA PAIN CENTERSEVANSVILLE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $1881.00 | 1700966710 - SURGERY CENTER OF KALAMAZOO LLC | 61694249 - (MI) SURGERY CENTER OF KALAMAZOO LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $520.00 | 1740918887 - ORTHOMIDWEST SURGERY CENTER BELOIT, LLC | 881260648 - (WI) ORTHOMIDWEST SURGERY CENTER BELOIT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $587.00 | 1982626974 - PHYSICIANS EYE SURGERY CENTER, INC | 911320378 - (WA) PHYSICIANS EYE SURGERY CENTER INC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $589.00 | 1831484567 - GRIFFISS EC, LLC, GRIFFISS EYE SURGERY CENTER | 263738675 - (NY) GRIFFISS EC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61867 | $268.00 | 1871729111 - RIVERVIEW AMBULATORY SURGICAL CENTER, LLC | 900456643 - (PA) RIVERVIEW AMBULATORY SURGICAL CE | PA | 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 61867 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61867 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 61867 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 |
| 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) |
| 61867-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) With Use Of Intraoperative Microelectrode Recording; First Array |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61867 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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