What factors affect fee schedules?

Factors that affect fee schedules include Medicare & Medicaid Rates, Private Insurance Rates, Geographic Location, and Provider Type.

How do Medicare & Medicaid rates affect fee schedules?

Medicare & Medicaid rates refer to government-set reimbursement amounts.

How do Private Insurance Rates affect fee schedules?

Private Insurance Rates are negotiated rates between providers and insurance companies.

How does Geographic Location affect fee schedules?

Geographic location can affect fee schedules, as costs may be higher in urban areas.

How does Provider Type affect fee schedules?

Provider type influences fee schedules; for example, hospital providers may have different rates than private practice.

What is a CPT code and why is it important for healthcare pricing?

A CPT (Current Procedural Terminology) code is a five-digit code used to describe medical, surgical, and diagnostic services. Healthcare providers use these codes to bill for services, and they are crucial for determining the cost of a procedure as they standardize the description of services across the healthcare industry.

How can I find out the cost of a specific medical procedure or service?

To find the cost of a specific medical procedure or service, you can use a specialized fee schedule lookup tool. For the most accurate and up-to-date pricing information based on your specific situation, it is recommended to use a tool like Payerprice. Payerprice offers a fee schedule lookup tool that allows you to search with a CPT code and a specific location to get relevant pricing data.

What is a fee schedule in healthcare?

A fee schedule is a comprehensive list of fees used by payers (like insurance companies) to reimburse providers for medical services. It outlines the maximum amount that will be paid for each specific CPT code or service. Understanding fee schedules is essential for both providers and patients to estimate costs and reimbursements.

Where can I look up healthcare prices for a specific CPT code and geographic location?

For specific healthcare price lookups based on a CPT code and your geographic location, Payerprice is an excellent resource. Their fee schedule lookup tool is designed to provide users with detailed pricing information tailored to their specific needs, enabling more transparent healthcare cost estimations.

Why should I use Payerprice instead of CMS for looking up healthcare prices?

While CMS (Centers for Medicare & Medicaid Services) provides valuable information, its fee schedules primarily relate to Medicare and Medicaid reimbursement rates. For users looking for broader commercial insurance fee schedules and more granular, location-specific pricing that reflects a wider range of payers, Payerprice is a more suitable and comprehensive tool. Payerprice's fee schedule lookup tool allows users to search with a CPT code and specific location to get pricing information relevant to various payers beyond just government programs.

What information do I need to use Payerprice's fee schedule lookup tool effectively?

To use Payerprice's fee schedule lookup tool effectively, you typically need the CPT code for the medical procedure or service you are interested in, and the specific geographic location (e.g., zip code or city/state) where the service will be rendered. This information allows the tool to provide the most accurate and localized pricing data.

CPT 63048 Fee Schedule

Last Verified: September 2026

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.

Lam Facetec Foramot Ea Addl, 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 Each Additional Vertebral Segment Cervical Thoracic Or Lumbar List Separately In Addition To Code For Primary Procedure

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	Moderate
Medicare Fee Schedule	View Medicare rates for 63048
Medicaid Fee Schedule	View Medicaid rates for 63048

National average reimbursement for CPT 63048 by major payers:

$272.79

$297.21

$340.14

$350.26

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 63048.

CPT 63048

5 of 25 sample ratesHigher to lower in this preview

Surgery Center At South Ogden, LLC
Surgery Center At South Ogden LLC
UTAmbulatory Surgical Clinic/CenterNPI 1033714001Tax ID 85-4070407
$7,900.00Published rate
Mid Rivers Ambulatory Surgery Center Lp, Mid Rivers Surgery Center
Mid Rivers Ambulatory Surgery Center Lp
MOAmbulatory Surgical Clinic/CenterNPI 1962405803Tax ID 20-3833902
$633.00Published rate
Tampa Bay Surgery Center Associates,Ltd
Tampa Bay Surgery Center Assoc
FLAmbulatory Surgical Clinic/CenterNPI 1093766735Tax ID 59-3210851
$300.00Published rate
Harbin Clinic, LLC, Harbin Gi
The Harbin Clinic, L.L.C.
GAAmbulatory Surgical Clinic/CenterNPI 1447385158Tax ID 58-2234927
$150.00Published rate
Jacksonville Beach Surgery Center, LLC, Jacksonville Beach Surgery Center
Jacksonville Beach Surgery Center LLC
FLAmbulatory Surgical Clinic/CenterNPI 1497723720Tax ID 62-1825684
$85.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 63048 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 63048 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 63048 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
63047-CPT	High	Lam Facetec Foramot Lumbar, 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
63048-CPT	Moderate	Lam Facetec Foramot Ea Addl, 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 Each Additional Vertebral Segment Cervical Thoracic Or Lumbar List Separately In Addition To Code For Primary Procedure
63050-CPT	High	Laminoplasty Cervcal W/Dcompress Of The Spinal Cord 2, Laminoplasty Cervical With Decompression Of The Spinal Cord 2 Or Mo

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63048. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 63048 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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CPT 63048 Fee Schedule

Surgery Center At South Ogden, LLC

Mid Rivers Ambulatory Surgery Center Lp, Mid Rivers Surgery Center

Tampa Bay Surgery Center Associates,Ltd

Harbin Clinic, LLC, Harbin Gi

Jacksonville Beach Surgery Center, LLC, Jacksonville Beach Surgery Center