CPT 61868 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 61868 by major payers:
$645.53
$725.45
$749.03
$837.66
| 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 61868 | ||||||
United | 61868 | $1049.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $1630.00 | 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 | 61868 | $385.00 | 1548254402 - LIVE OAK ENDOSCOPY CENTER, LLC | 10709517 - (FL) LIVE OAK ENDOSCOPY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $665.00 | 1831165331 - SPOKANE EYE CLINIC INC, PS, SPOKANE EYE SURGERY CENTER | 910852217 - (WA) SPOKANE EYE CLINIC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $420.00 | 1184697930 - THE ALEXANDRIA OPHTHALMOLOGY ASC LLC, WALLACE LASER AND SURGERY CENTER | 752830937 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $2945.00 | 1477552768 - COURT STREET SURGERY CENTER, LP | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $438.00 | 1801849427 - MAIN STREET ASC LLC, OPHTHALMIC ASSOCIATES SURGERY AND LASER CENTER | 383711415 - (PA) MAIN STREET ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $1274.00 | 1518375641 - NORTH ANAHEIM SURGERY CENTER, LLC | 364790127 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $410.00 | 1346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT | 383656538 - (TX) ENDOSCOPY CENTER AT MED POINT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $570.00 | 1891770814 - REGIONAL HAND CENTER OF CENTRAL CALIFORNIA, INC | 770521088 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $5729.00 | 1063735702 - OCHSNER MEDICAL CENTER, OCHSNER OUTPATIENT SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $291.00 | 1184600736 - MERIDIAN SURGERY CENTER, LLC | 300160065 - (MS) MERIDIAN SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $340.00 | 1780789024 - LINDEN SURGICAL CENTER, LLC | 223634504 - (NJ) LINDEN SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $524.00 | 1528039567 - PREMIER PROFESSIONAL SURGERY CENTER PC, PARKEYE SURGI CENTER | 381894684 - (MI) PARK EYE & SURGI CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61868 | $840.00 | 1386647402 - PHYSICIANS DAY SURGERY CENTER, LLC, PHYSICIANS DAY SURGERY CENTER, INC. | 593438026 - (FL) PHYSICIANS DAY SURGERY CENTER, INC. | FL | 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 61868 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61868 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 61868 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 |
|---|---|---|
| 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 |
| 61868-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) With Use Of Intraoperative Microelectrode Recording; Each Additional Array |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61868. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61868 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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