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 |
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 | $8336.00 | 1104220466 - ELITE SURGERY CENTER LLC | 320411327 - (PA) ELITE SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $16979.00 | 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 | 61891 | $1000.00 | 1649407180 - PAIN MDS INC | 270279190 - (AZ) PAIN MDS INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $6257.00 | 1437106846 - ANTIETAM UROSURGICAL CENTER LLC ASC | 522006832 - (MD) ANTIETAM UROSURGICAL CENTER LLC ASC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $5953.00 | 1053632372 - ORTHOATLANTA SURGERY CENTER OF AUSTELL, LLC | 272363967 - (GA) ORTHOATLANTA SURGERY CENTER OF AUSTELL LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $5468.00 | 1982880274 - BURLINGTON COUNTY ENDOSCOPY CENTER LLC | 208205206 - (NJ) BURLINGTON COUNTY ENDOSCOPY CENTER LLC | NJ | 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 | $7747.00 | 1962958223 - NORTHGLENN ENDOSCOPY CENTER LLC | 812984347 - (CO) NORTHGLENN ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $9834.00 | 1619218096 - SAN MARCOS ASC LLC | 800899088 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $4000.00 | 1225036601 - TALLGRASS SURGICAL CENTER, LLC | 481243206 - (KS) TALLGRASS SURGICAL CENTER, LLC | KS | 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 | $5270.00 | 1295385482 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $6544.31 | 1508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS | 470757164 - ALEGENT CREIGHTON HEALTH | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $1411.00 | 1699012682 - FSC INVESTMENTS, LLC, FLORISSANT SURGERY CENTER | 453808874 - (MO) FSC INVESTMENTS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 61891 | $7002.00 | 1487693123 - CLARKSVILLE SURGERY CENTER LLC | 621752518 - (TN) CLARKSVILLE SURGERY CENTER LLC | TN | 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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