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 |
| Medicare Fee Schedule | View Medicare rates for 62365 |
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 | $1472.00 | 1043239338 - NORTH VALLEY ENDOSCOPY CENTER LLC | 201729172 - (AZ) NORTH VALLEY ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $3569.00 | 1760808836 - OVERLAKE REPRODUCTIVE HEALTH INC PS., OVERLAKE REPRODUCTIVE HEALTH INC.- AMBULATORY SURGICAL FACILITY | 911796570 - (WA) OVERLAKE REPRODUCTIVE HEALTH, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $6087.00 | 1649515354 - SURGCENTER NORTHEAST LLC | 455554995 - (FL) SURGCENTER NORTHEAST, 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 | $6365.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $3700.00 | 1699272112 - HANOVER HILLS SURGERY CENTER, LLC | 822078645 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $4134.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | 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 | $550.00 | 1689035537 - YUMA ENDOSCOPY CENTER | 473656580 - (AZ) YUMA ENDOSCOPY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $1500.00 | 1750494423 - GEORGIA PAIN SPINE CENTER | 202427632 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $6588.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $8768.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $3357.00 | 1306353586 - SDG CASTLE ROCK ENDOSCOPY CENTER | 823765778 - (CO) SDG CASTLE ROCK ENDOSCOPY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $6365.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 62365 | $5000.00 | 1245759356 - DALLAS ASC, LLC, NORTH PARK HEART & VASCULAR SURGERY CENTER | 823468320 | TX | 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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