CPT 63035 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | Moderate |
National average reimbursement for CPT 63035 by major payers:
$309.33
$273.61
$327.44
$354.38
| 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 63035 | ||||||
United | 63035 | $125.00 | 1578722633 - GREENVILLE SURGERY CENTER LP, PIEDMONT SURGERY CENTER | 570965527 - (SC) GREENVILLE SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $100.00 | 1578508875 - CLERMONT AMBULATORY SURGICAL CENTER | 202139893 - (FL) CLERMONT AMBULATORY SURGICAL CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $566.00 | 1659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC | 461251610 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $1831.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $1446.00 | 1396742029 - GARLAND SURGICARE PARTNERS, LTD., BAYLOR SURGICARE AT GARLAND | 752764855 - (TX) GARLAND SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $434.00 | 1376605279 - MIDWEST CENTER FOR DAY SURGERY, LLC | 208103522 - (IL) MIDWEST CENTER FOR DAY SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $1135.00 | 1801058292 - METROPOLITAN SURGICAL INSTITUTE, LLC | 204513856 - (NJ) METROPOLITAN SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $566.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $143.00 | 1548896095 - CAPITAL ORTHOPAEDIC SURGERY CENTER, LLC, CAPITAL ORTHOPAEDIC SURGERY CENTER | 833923443 - (MD) CAPITAL ORTHOPAEDIC SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $506.00 | 1962714154 - SURGCENTER OF WHITE MARSH, LLC | 272873637 - (MD) SURGCENTER OF WHITE MARSH, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $68.00 | 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 | 63035 | $200.00 | 1205317054 - SKYLINE SURGERY CENTER, LLC, SKYLINE EYE SURGERY CENTER | 824134934 - (CO) SKYLINE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $4000.00 | 1386652667 - MACON OUTPATIENT SURGERY, LLC | 203027560 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $77.00 | 1356369755 - MADISON SURGERY CENTER, LLC | 631249522 - (AL) MADISON SURGERY CENTER, L.L.C. | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63035 | $163.00 | 1609977610 - UOC SURGICAL SERVICES, LTD. | 251890694 - (PA) UOC SURGICAL SERVICES LTD | PA | 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 63035 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63035 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 63035 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 |
|---|---|---|
| 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 |
| 63035-CPT | Moderate | Laminotomy (Hemilaminectomy), With Decompression Of Nerve Root(S), Including Partial Facetectomy, Foraminotomy And/Or Excision Of Herniated Intervertebral Disc; Each Additional Interspace, Cervical Or Lumbar (List Separately In Addition To Code For Primary Procedur |
| 63040-CPT | High | Laminotomy (Hemilaminectomy), With Decompression Of Nerve Root(S), Including Partial Facetectomy, Foraminotomy And/Or Excision Of Herniated Intervertebral Disc, Reexploration, Single Interspace; Cervical |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63035 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 63035) and we'll show you how you compare in 15 minutes or less.