CPT 63078 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 • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 63078 |
National average reimbursement for CPT 63078 by major payers:
$263.64
$282.72
$317.52
$335.65
| 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 63078 | ||||||
United | 63078 | $900.00 | 1033195912 - SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC, AVERA ENDOSCOPY/SURGICAL CENTER | 460461429 - (SD) SURGICAL ASSOCIATES ENDOSCOPY CLINIC LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $393.00 | 1811090350 - GREEN SURGERY CENTER LLC | 621770173 - (TN) GREEN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $50.00 | 1043284508 - WINTER HAVEN-SEBRING FL OPHTHALMOLOGY ASC LLC, EYE SURGERY & LASER CENTER OF SEBRING | 743072437 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $705.00 | 1518004696 - CENTURY CITY ENDOSCOPY, LLC | 954754975 - (CA) CENTURY CITY ENDOSCOPY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $277.00 | 1336310986 - LAPLATA AMBULATORY UROLOGICAL CENTER, L.L.C. | 262119326 - (MD) LAPLATA AMBULATORY UROLOGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1167.00 | 1336649565 - ADVANCED SURGICAL CARE OF ST. LOUIS, LLC | 823086965 - (MO) ADVANCED SURGICAL CARE OF ST LOUIS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1064.00 | 1548203888 - NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC, THE ORTHOPEDIC SURGERY CENTER OF ARIZONA | 202684773 - (AZ) NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $413.00 | 1841347143 - RUXTON SURGICENTER LLC | 522095835 - (MD) RUXTON SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $9124.00 | 1538292990 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $983.00 | 1245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN | 823682684 - (FL) SURGCENTER CLEARWATER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1290.00 | 1104189042 - FOOTHILLS SURGERY CENTER, LLC | 455328252 - (CO) FOOTHILLS SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $593.00 | 1053661108 - RESEARCH SURGICAL CENTER, LLC | 460558032 - RESEARCH SURGICAL CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1049.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $2153.00 | 1689651481 - TETON OUTPATIENT SERVICES LLC | 841412817 - (WY) TETON OUTPATIENT SERVICES LLC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $2705.00 | 1205327277 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | 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 63078 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63078 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 63078 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 |
|---|---|---|
| 63077-CPT | High | Discectomy, Anterior, With Decompression Of Spinal Cord And/Or Nerve Root(S), Including Osteophytectomy; Thoracic, Single Interspace |
| 63078-CPT | Moderate | Discectomy, Anterior, With Decompression Of Spinal Cord And/Or Nerve Root(S), Including Osteophytectomy; Thoracic, Each Additional Interspace (List Separately In Addition To Code For Primary Procedure) |
| 63081-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Anterior Approach With Decompression Of Spinal Cord And/Or Nerve Root(S); Cervical, Single Segment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63078. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63078 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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