CPT 63052 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 | • 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 |
National average reimbursement for CPT 63052 by major payers:
$326.34
$371.49
$364.77
$445.97
| 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 63052 | ||||||
United | 63052 | $112.00 | 1548374267 - DALLAS SURGI CENTER, INC. | 752199927 - (TX) DALLAS SURGI CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $555.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $643.00 | 1962626523 - CALLOWAY CREEK SURGERY CENTER LP | 141948102 - (TX) CALLOWAY CREEK SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $1096.00 | 1144283649 - SKY RIDGE SURGERY CENTER LP | 223877040 - (CO) SKY RIDGE SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $126.00 | 1992709851 - NOVAMED SURGERY CENTER OF CHICAGO-NORTHSHORE, LLC | 50540721 - (IL) NOVAMED SURGERY CENTER OF CHICAGONORTHSHORE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $443.41 | 1164003224 - RACHEL SILLIMAN | 350593390 - DEACONESS HOSPITAL INC | MI | Hospitalist Physician (208M00000X) |
United | 63052 | $2281.00 | 1093444010 - SUMMIT MEDICAL GROUP PA | 223487984 - SUMMIT MEDICAL GROUP, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $195.00 | 1841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC | 273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $546.00 | 1356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC | 842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $203.72 | 1083073035 - LILLIAN SILVA | 350593390 - DEACONESS HOSPITAL INC | VA | Certified Registered Nurse Anesthetist (367500000X) |
United | 63052 | $232.00 | 1437597812 - VIVERE HEALTH AUSTIN, LLC, VIVERE AUSTIN SURGERY CENTER | 611694454 - (TX) VIVERE HEALTH AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $78.00 | 1952354326 - CENTER OF SURGICAL EXCELLENCE OF VENICE FLORIDA LLC | 202807874 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $107.00 | 1154867562 - UROLOGIC AMBULATORY SURGERY CENTER, LLC | 814904405 - (MS) UROLOGIC AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $64.00 | 1508210378 - APEX MEDICAL SURGERY CENTER, LLC | 471906463 - (GA) APEX MEDICAL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63052 | $555.00 | 1881905792 - SURGCENTER PINELLAS, LLC | 271372259 - (FL) SURGCENTER PINELLAS, LLC | FL | 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 63052 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63052 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 63052 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 |
|---|---|---|
| 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) |
| 63053-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; Each Additional 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 63052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63052 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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