CPT 63001 Fee Schedule
Healthcare 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 • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63001 |
National average reimbursement for CPT 63001 by major payers:
$1,553.66
$1,683.93
$1,820.10
$2,046.31
| 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 63001 | ||||||
United | 63001 | $747.00 | 1588991228 - THE EYE SURGICAL CENTER OF FORT WAYNE, LLC | 271316595 - (IN) THE EYE SURGICAL CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $3240.00 | 1467499293 - ST CLOUD MN OPHTHALMOLOGY ASC LLC, ST. CLOUD CENTER FOR OPHTHALMIC SURGERY | 203853072 - (MN) ST CLOUD MN OPHTHALMOLOGY ASC LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $3400.00 | 1003357377 - NEPHROLOGY PHYSICIANS LLC | 352082018 - (IN) NEPHROLOGY PHYSICIANS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $1600.00 | 1497723720 - JACKSONVILLE BEACH SURGERY CENTER, LLC, JACKSONVILLE BEACH SURGERY CENTER | 621825684 - (FL) JACKSONVILLE BEACH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $955.70 | 1114946852 - CHRISTOPHER STEWART | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 63001 | $2416.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $8394.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $2605.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $4627.00 | 1669079992 - WOODBURY SURGERY CENTER, LLC | 853366699 - (MN) WOODBURY SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $4627.00 | 1518505809 - MAPLE GROVE CENTER FOR RESTORATIVE SURGERY | 853324771 - (MN) CENTER FOR RESTORATIVE SURGERY AT MAPLE GROVE LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $5400.00 | 1245862002 - QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC, QUINCY MEDICAL GROUP SURGERY CENTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $955.70 | 1427014331 - STEPHANIE PRESTON | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 63001 | $8394.00 | 1184680225 - CAPITAL CITY SURGICAL CENTER LLC, CAPITAL CITY SURGICAL CENTER LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $6973.00 | 1205327277 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63001 | $1810.00 | 1962743310 - WF ENDOSCOPY CENTER LLC | 611578919 | NC | 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 63001 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63001 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 63001 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 |
|---|---|---|
| 62380-CPT | High | Endoscopic Decompression Of Spinal Cord, Nerve Root(S), Including Laminotomy, Partial Facetectomy, Foraminotomy, Discectomy And/Or Excision Of Herniated Intervertebral Disc, 1 Interspace, Lumbar |
| 63001-CPT | High | Laminectomy With Exploration And/Or Decompression Of Spinal Cord And/Or Cauda Equina, Without Facetectomy, Foraminotomy Or Discectomy (Eg, Spinal Stenosis), 1 Or 2 Vertebral Segments; Cervical |
| 63003-CPT | High | Laminectomy With Exploration And/Or Decompression Of Spinal Cord And/Or Cauda Equina, Without Facetectomy, Foraminotomy Or Discectomy (Eg, Spinal Stenosis), 1 Or 2 Vertebral Segments; Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63001 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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