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 |
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 | $14053.00 | 1396774543 - WISCONSIN SURGERY CENTER LLC | 383661215 - (WI) WISCONSIN SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $5100.00 | 1275546434 - MOUNTAIN VIEW ENDOSCOPY CENTER LP | 201417318 - (CA) MOUNTAIN VIEW ENDOSCOPY CENTER, | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $5255.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $4500.00 | 1154624526 - THE AMBULATORY SURGERY CENTER AT ST. MARY, LLC | 272871206 - (PA) AMBULATORY SURGICAL CENTER AT ST. MARY'S | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $5926.00 | 1063757227 - PARKVIEW ORTHO CENTER, LLC | 611697669 - (IN) PARKVIEW ORTHO CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $6087.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $4328.00 | 1649944521 - PRECISION BONE AND JOINT SURGERY CENTER | 861302912 - (FL) PRECISION BONE AND JOINT SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $6973.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | 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 | $2760.00 | 1730124124 - ENDOSCOPY CENTER OF SANTA MARIA INC, THE ENDOSCOPY CENTER OF SANTA MARIA, INC. | 470880655 - (CA) ENDOSCOPY CENTER OF SANTA MARIA, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $1210.00 | 1710047188 - ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC, ARROWHEAD ENDOSCOPY CENTER. | 205706445 - (AZ) ARROWHEAD ENDOSCOPY AND PAIN MAN | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $6000.00 | 1083715148 - ASC SURGICAL VENTURES, LLC, OSMC OUTPATIENT SURGERY CENTER | 351995261 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $5302.00 | 1790066876 - CAROMONT HEALTH SERVICES, INC., CAROMONT ENDOSCOPY CENTER | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $3300.00 | 1841840758 - GULFSTREAM PARC ASC LLC | 843025864 - (TX) GULFSTREAM PARC ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63003 | $3373.00 | 1922438472 - PARK AMBULATORY SURGERY CENTER, LLC | 463665760 - (TX) PARK AMBULATORY SURGERY CENTER LLC | 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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