CPT 63091 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 • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 80 - Assistant surgeon |
| Complexity Level | Moderate |
National average reimbursement for CPT 63091 by major payers:
$229.43
$248.69
$282.38
$296.39
| 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 63091 | ||||||
United | 63091 | $1893.00 | 1609907211 - SHREWSBURY SURGERY CENTER, LLC, SHREWSBURY SURGERY CENTER | 223651945 - (NJ) SHREWSBURY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $2302.00 | 1144283649 - SKY RIDGE SURGERY CENTER LP | 223877040 - (CO) SKY RIDGE SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $375.00 | 1437691177 - FRESENIUS VASCULAR CARE CINCINNATI ASC LLC, AZURA SURGERY CENTER CINCINNATI | 814225843 - (OH) FRESENIUS VASCULAR CARE CINCINNATI ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $1891.00 | 1386028439 - JOHNSTON MEMORIAL HOSPITAL, INC, JOHNSTON MEMORIAL SURGERY CENTER | 540544705 - JOHNSTON MEMORIAL HOSPITAL INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $1049.00 | 1245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC | 845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $450.00 | 1528501939 - AMERICAN ACCESS CARE OF FLORIDA ASC LLC, AZURA SURGERY CENTER PLANTATION | 814131878 - (FL) AMERICAN ACCESS CARE OF FLORIDA ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $200.00 | 1447267554 - CEDAR SURGICAL ASSOCIATES LC | 870657848 - (UT) CEDAR SURGICAL ASSOCIATES LC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $807.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $523.00 | 1306281563 - VIVERE HEALTH NEW ORLEANS, LLC, VIVERE AUDUBON SURGERY CENTER | 300726133 - (LA) VIVERE HEALTH NEW ORLEANS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $460.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $780.00 | 1407327356 - ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC, SURGERY CENTER OF BEVERLY HILLS LLC | 832822673 - (CA) ADVANCED SURGICAL CENTER OF BEVERLY HILLS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $1339.00 | 1962879932 - GUILFORD SURGERY CENTER LLC | 473071064 - (CT) GUILFORD SURGERY CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $2785.00 | 1083912745 - RED ROCKS SURGERY CENTERS, LLC | 271095323 - (CO) RED ROCKS SURGERY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $775.00 | 1487280871 - MARYLAND AMBULATORY SURGERY CENTER LLC | 845098442 - (MD) MARYLAND AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63091 | $852.00 | 1609871847 - THE SURGERY CENTER, LLC | 582520623 - (GA) THE SURGERY CENTER LLC | GA | 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 63091 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63091 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 63091 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 |
|---|---|---|
| 63090-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Transperitoneal Or Retroperitoneal Approach With Decompression Of Spinal Cord, Cauda Equina Or Nerve Root(S), Lower Thoracic, Lumbar, Or Sacral; Single Segment |
| 63091-CPT | Moderate | Vertebral Corpectomy (Vertebral Body Resection) Partial Or Complete Transperitoneal Or Retroperitoneal Approach With Decompression Of Spinal Cord Cauda Equina Or Nerve Root(S) Lower Thoracic Lumbar Or Sacral; Each Additional Segment (List Separately In Addition To Code For Primary Procedure) |
| 63101-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Lateral Extracavitary Approach With Decompression Of Spinal Cord And/Or Nerve Root(S) (Eg, For Tumor Or Retropulsed Bone Fragments); Thoracic, 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 63091. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63091 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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