CPT 62365 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 62365 by major payers:
$398.53
$430.19
$439.22
$515.45
| 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 62365 | ||||||
United | 62365 | $3425.00 | 1417935206 - DIGESTIVE DISEASE CENTER, LP, MEMORIAL CARE DIGESTIVE CARE CENTER SADDLEBACK MEMORIAL, AN AFFILIATE | 330292435 - (CA) DIGESTIVE DISEASE CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $3788.00 | 1821141284 - CENTER FOR HEALTH AMBULATORY SURGERY CENTER, LLC | 205557171 - (IL) CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $1500.00 | 1942548870 - ISPM ASC AT CAMP CREEK LLC, ALLIANCE SURGERY CENTER AT CAMP CREEK | 461000991 - (GA) ISPM ASC AT CAMP CREEK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $1259.00 | 1225039761 - ENDOSCOPY CENTER OF ST THOMAS LLC, ST THOMAS MEDICAL GROUP ENDOSCOPY CENTER | 621512411 - (TN) ENDOSCOPY CENTER OF ST THOMAS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $5000.00 | 1568950996 - HOLLYWOOD REGIONAL SURGERY CENTER LLC | 825140248 - (FL) HOLLYWOOD REGIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $4865.00 | 1366041469 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $924.00 | 1922144484 - INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | 202908826 - (MO) INTERVENTIONAL PAIN CENTER OF CHESTERFIELD L L C | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $1624.00 | 1659408300 - CENTRE AVENUE GROUP, LLC, EAST SIDE SURGERY CENTER | 202831701 - (PA) CENTRE AVENUE GROUP, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $3275.00 | 1871924027 - PRESTON SURGERY CENTER, LLC | 462415142 - (TX) PRESTON SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $7229.00 | 1366515504 - RIVERSIDE AMBULATORY SURGERY CENTER, LLC, THE ENDOSCOPY & COLONOSCOPY CENTER | 205227186 - (MO) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $2781.00 | 1033102140 - SSC HOLDINGS LLC, SEDONA SURGERY CENTER | 470887316 - (CA) SSC HOLDINGS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $6300.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $6020.00 | 1649287269 - BAPTIST PLAZA SURGICARE LP, SAINT THOMAS SURGERY CENTER - MIDTOWN | 800033564 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $2940.00 | 1164811923 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN AMBULATORY SURGERY CENTER-LEXINGTON | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $1913.00 | 1447599659 - SOUTHEAST EYE SURGERY CENTER, LLC | 455054338 - (TN) SOUTHEAST EYE 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 62365 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 62365 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 62365 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 |
|---|---|---|
| 62362-CPT | Moderate | Implantation Or Replacement Of Device For Intrathecal Or Epidural Drug Infusion; Programmable Pump, Including Preparation Of Pump, With Or Without Programming |
| 62365-CPT | Moderate | Removal Of Subcutaneous Reservoir Or Pump |
| 62367-CPT | Low | Electronic Analysis Of Programmable, Implanted Pump For Intrathecal Or Epidural Drug Infusion (Includes Evaluation Of Reservoir Status, Alarm Status, Drug Prescription Status); Without Reprogramming Or Refill |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 62365. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 62365 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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