CPT 63051 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 • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63051 |
National average reimbursement for CPT 63051 by major payers:
$2,161.90
$2,331.63
$2,454.29
$2,838.79
| 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 63051 | ||||||
United | 63051 | $802.00 | 1962920751 - WEST END SURGICAL, LLC, OREGON SURGICAL INSTITUTE | 812758812 - (OR) WEST END SURGICAL LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $408.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $2172.00 | 1760912554 - BAYLOR SURGICARE AT BAYLOR PLANO, LLC, BAYLOR SCOTT & WHITE SURGICARE AT PLANO ALLIANCE | 813127185 - (TX) BAYLOR SURGICARE AT BAYLOR PLANO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1064.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1049.00 | 1295163715 - BLUFFTON OKATIE SURGERY CENTER, L.L.C. | 364730753 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $625.00 | 1003260498 - NORTHWEST ENDO CENTER LLC | 812338623 - (IL) NORTHWEST ENDO CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1028.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1000.00 | 1225439250 - ADVANCED SURGERY CENTER OF SAN ANTONIO, LLC | 465742281 - (TX) ADVANCED SURGERY CENTER OF SAN ANTONIO, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1002.55 | 1417944778 - MERRIMACK VALLEY ENDOSCOPY CENTER | 43578297 - (MA) MERRIMACK VALLEY ENDOSCOPY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $629.00 | 1013298926 - MATTHEWS SURGERY CENTER, LLC | 273634811 - (NC) MATTHEWS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $2785.00 | 1518359181 - ARAPAHOE SURGICENTER, LLC | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $76.00 | 1063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER | 861925762 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $350.00 | 1417333295 - IDOX3 LLC, TRI-STATE SURGERY CENTER | 473757893 - (OH) IDOX3 LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $1064.00 | 1326453325 - CAPITAL CITY SURGERY CENTER OF FLORIDA LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63051 | $997.00 | 1568583896 - EASTERN ORANGE AMBULATORY SURGERY CENTER, LLC | 205350007 - (NY) EASTERN ORANGE ASC LLC | NY | 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 63051 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63051 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 63051 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 |
|---|---|---|
| 63050-CPT | High | Laminoplasty, Cervical, With Decompression Of The Spinal Cord, Two Or More Vertebral Segments; |
| 63051-CPT | High | Laminoplasty, Cervical, With Decompression Of The Spinal Cord, 2 Or More Vertebral Segments; With Reconstruction Of The Posterior Bony Elements (Including The Application Of Bridging Bone Graft And Non-Segmental Fixation Devices (Eg, Wire, Suture, Mini-Plates), Whe |
| 63052-CPT | Moderate | Laminectomy, Facetectomy, Or Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord, Cauda Equina And/Or Nerve Root[S] [Eg, Spinal Or Lateral Recess Stenosis]), During Posterior Interbody Arthrodesis, Lumbar; Single Vertebral Segment (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63051. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63051 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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