CPT 63085 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 • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63085 |
National average reimbursement for CPT 63085 by major payers:
$2,385.90
$2,622.42
$2,696.68
$3,192.65
| 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 63085 | ||||||
United | 63085 | $2785.00 | 1619265295 - KINGWOOD SURGERY CENTER LLC | 621771718 - (TX) KINGWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $725.00 | 1649393695 - COLUMBIA MD ORTHOPAEDIC ASC, LLC, HICKORY RIDGE SURGERY CENTER | 522377233 - (MD) COLUMBIA MD ORTHOPAEDIC ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $410.00 | 1144827114 - GULFSTREAM SURGICAL FORT WORTH LLC | 851495125 - (TX) GULFSTREAM SURGICAL FORT WORTH | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $404.00 | 1487094058 - COMPREHENSIVE PAIN CENTER FOR SURGERY, FOUNTAINS SPECIALTY SURGICAL CENTER | 460896509 - (MS) COMPREHENSIVE PAIN CENTER FOR SURGERY | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $104.00 | 1225414246 - LV SURGERY CENTER LLC | 473021380 - (NV) LV SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $452.00 | 1932390234 - RENO ORTHOPAEDIC SURGERY CENTER LLC | 208256389 - (NV) RENO ORTHOPAEDIC SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $1049.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $695.00 | 1376574814 - ROCHESTER ENDOSCOPY & SURGERY CENTER, L.L.C. | 61683897 - (MI) ROCHESTER ENDOSCOPY SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $600.00 | 1639290026 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $1049.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $2302.00 | 1144283649 - SKY RIDGE SURGERY CENTER LP | 223877040 - (CO) SKY RIDGE SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $283.00 | 1285283432 - JONESBORO AMBULATORY SURGERY CENTER, LLC | 832479059 - (AR) JONESBORO AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $6623.00 | 1164486809 - SAINT LUKE'S SURGICENTER | 470853481 - (MO) SAINT LUKES SURGICENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $2730.00 | 1205869211 - ROANOKE SURGERY CENTER, LP | 61755240 - (VA) ROANOKE SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63085 | $897.00 | 1346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | 472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY 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 63085 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63085 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 63085 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 |
|---|---|---|
| 63082-CPT | Moderate | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Anterior Approach With Decompression Of Spinal Cord And/Or Nerve Root(S); Cervical, Each Additional Segment (List Separately In Addition To Code For Primary Procedure) |
| 63085-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Transthoracic Approach With Decompression Of Spinal Cord And/Or Nerve Root(S); Thoracic, Single Segment |
| 63086-CPT | Moderate | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Transthoracic Approach With Decompression Of Spinal Cord And/Or Nerve Root(S); Thoracic, 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 63085. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63085 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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