CPT 61891 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 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 61891 |
National average reimbursement for CPT 61891 by major payers:

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| 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 61891 | ||||||
United | 61891 | $2413.00 | 1235102344 - THE HARLINGEN ENDOSCOPY CENTER LP, VALLEY ENDOSCOPY CENTER | 621839180 - (TX) THE HARLINGEN ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $1000.00 | 1649407180 - PAIN MDS INC | 270279190 - (AZ) PAIN MDS INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $3400.00 | 1972549491 - UNION CITY ASC LLC, SUMMIT ENDOSCOPY CENTER | 621625423 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $6500.00 | 1689236242 - LEE MEMORIAL HEALTH SYSTEM, LEE HEALTH UROLOGY SURGERY CENTER | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $1586.00 | 1164083911 - EVERETT ROAD ASC, LLC, EVERETT ROAD SURGERY CENTER | 833542382 - (NY) EVERETT ROAD ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $11558.00 | 1013964063 - BRISTOL SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $4697.00 | 1184900102 - METROPOLITAN NEW JERSEY, LLC, METROPOLITAN SURGERY CENTER | 453003521 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $4456.00 | 1356643944 - UNION SURGERY CENTER, LLC | 272373691 - (NJ) UNION SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $4376.00 | 1184749673 - WAYNE SURGICAL CENTER LLC | 223535325 - (NJ) WAYNE SURGICAL CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $4724.00 | 1386618783 - LEWES DE ENDOSCOPY ASC LLC, SEASIDE ENDOSCOPY PAVILION | 562299727 - (DE) LEWES DE ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $2970.00 | 1881736734 - MILLENIA SURGERY CENTER LLC | 562384725 - (FL) MILLENIA SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $15464.00 | 1609253392 - GLBESC, LLC, MEMORIALCARE OUTPATIENT SURGICAL CENTER LONG BEACH | 473495605 - (CA) GLBESC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $2445.00 | 1891857850 - CARES AMBULATORY SURGERY SERVICES | 223557777 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $1436.00 | 1003036310 - MIDWEST ENDOSCOPY CENTER LLC | 208292570 - (IL) MIDWEST ENDOSCOPY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $3787.00 | 1609907211 - SHREWSBURY SURGERY CENTER, LLC, SHREWSBURY SURGERY CENTER | 223651945 - (NJ) SHREWSBURY SURGERY CENTER 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 61891 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61891 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 61891 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 |
|---|---|---|
| 61891-CPT | Moderate | Revision Or Replacement Of Skull-Mounted Cranial Neurostimulator Pulse Generator Or Receiver With Connection To Depth &/Or Cortical Strip - Commercial Rn Review>=1/1/2024 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61891. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61891 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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