CPT 63020 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 63020 by major payers:
$1,553.31
$1,579.93
$1,730.66
$1,890.10
| 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 63020 | ||||||
United | 63020 | $6365.00 | 1396174454 - SURGERY CENTER OF SCOTTSDALE LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $8394.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $2237.00 | 1598372963 - ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | 853147678 - (GA) ALLIANCE SURGERY CENTER AT PEACHTREE CITY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $9182.00 | 1427491547 - MEMORIAL HERMANN TEXAS INTERNATIONAL ENDOSCOPY CENTER, LLC, TEXAS INTERNATIONAL ENDOSCOPY CENTER | 462464605 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $4589.00 | 1548456478 - WILMINGTON ASC LLC, WILMINGTON HEALTH AMBULATORY SURGERY CENTER | 870883587 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $3400.00 | 1053385856 - JACKSON OPHTHALMOLOGY ASC LLC, PHYSICIANS SURGERY CENTER | 752842260 - (TN) JACKSON OPHTHALMOLOGY ASC, LLC DBA PHYSICIANS SUR | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $5484.00 | 1881667368 - FLORHAM PARK ENDOSCOPY ASC LLC, FLORHAM PARK ENDOSCOPY CENTER | 621774936 - (NJ) FLORHAM PARK ENDOSCOPY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $6492.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $5963.00 | 1962920751 - WEST END SURGICAL, LLC, OREGON SURGICAL INSTITUTE | 812758812 - (OR) WEST END SURGICAL LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $1631.00 | 1780767673 - EYE CARE SURGERY CENTER OF SOUTHAVEN,LLC | 30527649 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $6183.00 | 1821510579 - NOVANT HEALTH BRUNSWICK ENDOSCOPY CENTER, LLC, NOVANT HEALTH BRUNSWICK ENDOSCOPY | 820831203 - (NC) NOVANT HEALTH BRUNSWICK ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $8394.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $3163.00 | 1962893354 - WESTMORELAND ASC, LLC, APEX SURGICAL CENTER | 462808005 - (NY) WESTMORELAND ASC, LLC DBA APEX | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $1750.00 | 1356369755 - MADISON SURGERY CENTER, LLC | 631249522 - (AL) MADISON SURGERY CENTER, L.L.C. | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63020 | $8394.00 | 1447797105 - SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC, SOUTH DENVER SURGERY CENTER | 364821257 - (CO) SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | CO | 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 63020 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63020 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 63020 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 |
|---|---|---|
| 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 |
| 63020-CPT | High | Laminotomy (Hemilaminectomy) With Decompression Of Nerve Root(S) Including Partial Facetectomy Foraminotomy And/Or Excision Of Herniated Intervertebral Disk Including Open And Endoscopically- Assisted Approaches; 1 Interspace Cervical |
| 63030-CPT | High | Laminotomy (Hemilaminectomy), With Decompression Of Nerve Root(S), Including Partial Facetectomy, Foraminotomy And/Or Excision Of Herniated Intervertebral Disc; 1 Interspace, Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63020 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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