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 |
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 | $115.00 | 1447220082 - WESTERN PA SURGERY CENTER, WEXFORD BRANCH, LLC, WESTERN PA SURGERY CENTER | 251826912 - (PA) WESTERN PA SURGERY CENTER | PA | 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 | 63078 | $2517.00 | 1780797910 - CRYSTAL CITIES SURGERY CENTER, TWIN CITIES SURGERY CENTER | 260839397 | MO | 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 | $470.00 | 1497740872 - SHASTA EYE SURGEONS INC, SURGERY CENTER OF NORTHERN CALIFORNIA | 205757123 - (CA) SHASTA EYE SURGEONS INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $2785.00 | 1871912485 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, SOUTH DENVER ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $289.00 | 1598847139 - ORTHOPAEDIC ASSOCIATES SURGERY CENTER, LLC | 582623564 - (GA) ORTHOPAEDIC ASSOCIATES SURGERY CTR, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $681.00 | 1881024271 - DAKOTA GASTROENTEROLOGY, LTD | 383908818 - (ND) DAKOTA GASTROENTEROLOGY LTD. | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $540.00 | 1750469789 - ORTHOPEDIC SURGERY CENTER LLC, ORTHOPEDIC SURGERY CENTER | 364568309 - (LA) ORTHOPEDIC SURGERY CENTER, LLC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1050.00 | 1043297872 - CENTRAL JERSEY AMBULATORY SURGICAL CENTER, LLC | 223669777 - (NJ) CENTRAL JERSEY AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $983.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $91.00 | 1114990736 - TULSA OK OPHTHALMOLOGY ASC LLC, EYE SURGERY CENTER OF TULSA | 743051552 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $874.00 | 1881020899 - SURGCENTER OF CASTLE ROCK LLC | 825207935 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $518.00 | 1952535502 - PLATEAU SURGERY CENTER | 264769256 - (TN) PLATEAU SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63078 | $1231.00 | 1194935577 - MILLENNIUM SURGICAL CENTER LLC | 205225327 - (NJ) MILLENNIUM SURGICAL CENTER, LLC | NJ | 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 | High | Discectomy, Anterior, With Decompression Of Spinal Cord And/Or Nerve Root(S), Including Osteophytectomy; Thoracic, Single Interspace |
| 63078 | 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 | 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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