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See a sample rate comparisonHealthcare 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 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 62100 |
| Medicaid Fee Schedule | View Medicaid rates for 62100 |
National average reimbursement for CPT 62100 by major payers:

$2,000.11

$2,172.27

$2,235.76

$2,557.79
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Centinela Valley Endoscopy Center Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 62100 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 62100 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 62100 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 |
|---|---|---|
| 62000-CPT | High | Elevation Of Depressed Skull F, Elevation Of Depressed Skull Fracture Simple Extraduralelevation Of Depressed Skull Fracture Simple Extradural |
| 62005-CPT | High | Elevation Of Depressed Skull F, Elevation Of Depressed Skull Fracture Compound Orcomminuted Extradural Elevation Of Depressed Skull Fracture Compound Or |
| 62010-CPT | High | Elevation Of Depressed Skull F, Elevation Of Depressed Skull Fracture With Repairof Duraandor Debridement Of Brain Elevation Of Depressed Skull Fracture With Repair Of Dura |
| 62100-CPT | High | Seal Spinal Fluid Leak, Surgery To Seal Off An Opening In The Membrane Covering The Brain. The Opening Has Allowed Cerebrospinal Fluid To Leak Into The Sinuses. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 62100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 62100 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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