CPT 63003 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 63003 |
National average reimbursement for CPT 63003 by major payers:
$1,558.05
$1,688.17
$1,782.96
$2,051.32
| 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 63003 | ||||||
United | 63003 | $2626.00 | 1427355080 - PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC, PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK, LLC | 272900107 - (GA) PINNACLE ORTHOPAEDICS SURGERY CENTER WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $8818.00 | 1720603079 - TEXAS HEALTH SURGERY CENTER CHISHOLM TRAIL, LLC | 851225852 - (TX) TEXAS HEALTH SURGERY CENTER CHISHOLM TRAIL LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $2109.00 | 1265438303 - EYE SURGERY CENTER OF CHATTANOOGA, LLC | 200149350 - (TN) EYE SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $3322.00 | 1902864879 - SPOKANE SURGERY CENTER LTD PS | 911336886 - (WA) SPOKANE SURGERY CENTER LTD | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $3772.00 | 1346865078 - PANHANDLE OUTPATIENT SURGERY CENTER | 833975146 - (FL) PANHANDLE OUTPATIENT SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $5000.00 | 1952071920 - LAKEVIEW SURGERY CENTER, LLC | 872359088 - (FL) LAKEVIEW SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $2200.00 | 1376542076 - FREDERICK SURGICAL CENTER, LLC | 521652443 - (MD) FREDERICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $3288.00 | 1043254162 - FVOSA SURGICAL PARTNERS, LLC, ORTHOPEDIC & SPORTS SURGERY CENTER | 202394424 - (WI) FVOSA SURGICAL PARTNERS, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $4227.00 | 1114584786 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $1812.00 | 1053685677 - ARKANSAS CENTER FOR SURGICAL EXCELLENCE | 454640707 - (AR) ARKANSAS CENTER FOR SURGICAL EXCELLENCE | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $6492.00 | 1346383155 - BRIARCLIFF AMBULATORY SURGERY CENTER LP, BRIARCLIFF SURGERY CENTER | 202852584 - (MO) BRIARCLIFF AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $7172.00 | 1316449168 - SURGERY CENTER AT ST. VINCENT, LLC, EAST PAVILION SURGERY CENTER | 813129674 - (OR) SURGERY CENTER AT ST VINCENT LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $2194.00 | 1528142726 - GENORTHO, LLC, CROW VALLEY ORTHOPAEDIC SURGERY CENTER | 203406994 - (IA) GENORTHO LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $9182.00 | 1124492541 - MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC | 371796296 - (TX) MEMORIAL HERMANN SURGERY CENTER PINECROFT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $4000.00 | 1295233658 - LEGENT OUTPATIENT SURGERY WESTOVER HILLS, LLC | 823717201 | 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 63003 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63003 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 63003 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 |
|---|---|---|
| 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 |
| 63005-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; Lumbar, Except For Spondylolisthesis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63003. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63003 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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