CPT 63046 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 • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 63046 by major payers:
$1,521.35
$1,670.65
$1,834.23
$2,044.13
| 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 63046 | ||||||
United | 63046 | $8755.00 | 1972874907 - CAPITAL CITY SURGERY CENTER, LLC | 260804803 - (NC) CAPITAL CITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $3912.00 | 1861418378 - MAPLEWOOD AMBULATORY SURGERY CENTER, INC. | 752730666 - (TX) MAPLEWOOD AMBULATORY SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $1937.00 | 1407851090 - WICHITA FALLS ENDOSCOPY CENTER | 200474975 - (TX) WICHITA FALLS ENDOSCOPY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $3200.00 | 1871596114 - NORTHERN ARIZONA SURGICENTER, LLC | 860747413 - (AZ) NORTHERN ARIZONA SURGICENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $3100.00 | 1427577840 - DIALYSIS ACCESS CENTER OF CINCINNATI, INC. | 815023998 - (OH) DIALYSIS ACCESS CENTER OF CINCINNATI INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $955.15 | 1649606815 - AMANDA ROMERHAUSEN | 350593390 - DEACONESS HOSPITAL INC | IN | Acute Care Nurse Practitioner (363LA2100X) |
United | 63046 | $2078.86 | 1629097639 - DEACONESS HOSPITAL, INC., <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 63046 | $6683.00 | 1245749258 - FOCUS HAND SURGICENTER LLC, FOCUS HAND AND ARM SURGERY CENTER | 822523843 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $3995.00 | 1093461410 - INFIRMARY ASC | 871933440 - (AL) INFIRMARY ASC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $979.00 | 1326189499 - KUNESH EYE SURGERY CENTER | 311298414 - (OH) KUNESH EYE SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $4170.00 | 1447489695 - AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, L.L.C., VIRTUA CENTER FOR SURGERY | 208643005 - (NJ) AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $9182.00 | 1366776106 - MEMORIAL HERMANN SURGERY CENTER RICHMOND, LLC, MEMORIAL HERMANN SURGERY CENTER RICHMOND | 270552583 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $6492.00 | 1003004482 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $6087.00 | 1841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC | 592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63046 | $6365.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | 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 63046 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63046 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 63046 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 |
|---|---|---|
| 63045-CPT | High | Laminectomy, Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root(S), (Eg, Spinal Or Lateral Recess Stenosis)), Single Vertebral Segment; Cervical |
| 63046-CPT | High | Laminectomy, Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root(S), (Eg, Spinal Or Lateral Recess Stenosis)), Single Vertebral Segment; Thoracic |
| 63047-CPT | High | Laminectomy, Facetectomy And Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root(S), (Eg, Spinal Or Lateral Recess Stenosis)), Single Vertebral Segment; Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63046. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63046 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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