CPT 62304 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • GC - Service performed by resident under supervision • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 62304 |
National average reimbursement for CPT 62304 by major payers:
$302.36
$341.74
$357.93
$420.22
| 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 62304 | ||||||
United | 62304 | $2350.00 | 1558331801 - MEMORIAL HERMANN SURGERY CENTER, MEMORIAL HERMANN SURGERY CENTER, THE WOODLANDS | 201765863 - (TX) MEMORIAL HERMANN SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $708.00 | 1174588206 - CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | 581709761 - (SC) CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $204.00 | 1023256187 - TAMPA SURGERY CENTER LLC | 264008716 - (FL) TAMPA SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $1625.00 | 1720161615 - MANKATO SURGICAL CENTER, L.L.C., MANKATO SURGERY CENTER | 411924647 - (MN) MANKATO SURGICAL CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $392.00 | 1306260815 - SURGERY CENTER OF EYE SPECIALISTS OF INDIANA, PC | 351938206 - (IN) SURGERY CENTER OF EYE SPECIALISTS OF INDIANA PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $1963.00 | 1982716106 - THR/STT SOUTHLAKE ASC, LLC | 201728912 - (TX) THRSTT SOUTHLAKE ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $420.00 | 1063466118 - VALLEY SURGICAL CENTER INC | 204211574 - (PA) VALLEY SURGICAL CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $408.00 | 1487187076 - GREEN VALLEY SURGERY CENTER LLC | 812240255 - (NV) GREEN VALLEY SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $464.00 | 1073588646 - ESCONDIDO CA ENDOSCOPY ASC LP, PARKWAY ENDOSCOPY CENTER | 201627039 - (CA) ESCONDIDO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $436.29 | 1235391491 - JAMIE DAVISON | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 62304 | $128.00 | 1447279369 - EYE CENTER OF NORTH FLORIDA, P.A., THE LASER & SURGERY CENTER | 522107690 - (FL) EYE CENTER OF NORTH FLORIDA, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $1050.00 | 1043297872 - CENTRAL JERSEY AMBULATORY SURGICAL CENTER, LLC | 223669777 - (NJ) CENTRAL JERSEY AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $416.00 | 1215178835 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $220.00 | 1023055001 - ZION AMBULATORY CENTER LLC | 203243084 - (MD) ZION AMBULATORY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62304 | $676.00 | 1750378295 - BRAINERD LAKES SURGERY CENTER L L C | 200113449 - (MN) BRAINERD LAKES SURGERY CENTER, LLC | MN | 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 62304 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 62304 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 62304 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 |
|---|---|---|
| 62303-CPT | Moderate | Once Per Dos Myelography Via Lumbar Injection, Including Radiological Supervision And Interpretation; Thoracic |
| 62304-CPT | Moderate | Once Per Dos Myelography Via Lumbar Injection, Including Radiological Supervision And Interpretation; Lumbosacral |
| 62305-CPT | Moderate | Myelography Via Lumbar Injection Including Radiological Supervision And Interpretation; 2 Or More Regions (Eg Lumbar/Thoracic Cervical/ Thoracic Lumbar/Cervical Lumbar/Thoracic/ Cervical) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 62304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 62304 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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