CPT 63016 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 63016 |
National average reimbursement for CPT 63016 by major payers:
$1,915.88
$2,070.90
$2,226.47
$2,517.52
| 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 63016 | ||||||
United | 63016 | $3605.00 | 1194716191 - AMBULATORY SURGICAL CENTER OF UNION COUNTY, LLC | 223740023 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $4443.00 | 1093088999 - CHIPPENHAM AMBULATORY SURGERY CENTER, LLC | 371587067 - (VA) CHIPPENHAM AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $21685.69 | 1649392242 - ST. CLAIR MEMORIAL HOSPITAL | 251010303 - (PA) ST CLAIR HEALTH CORPORATION | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $2585.00 | 1316290380 - ATHENS SURGERY CENTER LLC, THE SURGERY CENTER OF ATHENS | 800812776 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $2600.00 | 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 | 63016 | $4234.00 | 1992721591 - DAY SURGERY CENTER OF NORTH TEXAS LTD | 260308454 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $530.00 | 1023551413 - MID-BRONX ENDOSCOPY CENTER LLC | 471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $1190.00 | 1801811773 - DUPAGE EYE SURGERY CENTER, LLC | 920189811 - (IL) DUPAGE EYE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $6095.00 | 1639694797 - UCSD CENTER FOR SURGERY OF ENCINITAS, L.P. | 822326631 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $2564.12 | 1124297361 - REJMON DEDAJ | 350593390 - DEACONESS HOSPITAL INC | KY | Pulmonary Disease Physician (207RP1001X) |
United | 63016 | $4627.00 | 1255001525 - ALLINA HEALTH SURGERY CENTER- BROOKLYN PARK, LLC | 871746250 - (MN) ALLINA HEALTH SURGERY CENTER BROOKLYN PARK LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $4312.00 | 1568505899 - BON SECOURS SURGERY CENTER AT HARBOUR VIEW, LLC, BON SECOURS SURGERY CENTER AT HARBOUR VIEW | 208302537 - (VA) BON SECOURS SURGERY CENTER AT HARBOUR VIEW LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $6526.00 | 1710321328 - VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | 800864336 - (CA) VALLEY PHYSICIANS SURGERY CENTER OF NORTHRIDGE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $2223.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63016 | $5513.00 | 1841342789 - SURGERY CENTER JV, THE SURGERY CENTER OF HUNTSVILLE | 621230866 - (AL) THE SURGERY CENTER OF HUNTSVILLE | AL | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 63016 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63016 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 63016 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 |
|---|---|---|
| 63015-CPT | High | Laminectomy With Exploration And/Or Decompression Of Spinal Cord And/Or Cauda Equina, Without Facetectomy, Foraminotomy Or Discectomy (Eg, Spinal Stenosis), More Than 2 Vertebral Segments; Cervical |
| 63016-CPT | High | Laminectomy With Exploration And/Or Decompression Of Spinal Cord And/Or Cauda Equina, Without Facetectomy, Foraminotomy Or Discectomy (Eg, Spinal Stenosis), More Than 2 Vertebral Segments; Thoracic |
| 63017-CPT | High | Laminectomy With Exploration And/Or Decompression Of Spinal Cord And/Or Cauda Equina, Without Facetectomy, Foraminotomy Or Discectomy (Eg, Spinal Stenosis), More Than 2 Vertebral Segments; Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63016 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 63016) and we'll show you how you compare in 15 minutes or less.