CPT 63101 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 • 11 - Office |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63101 |
National average reimbursement for CPT 63101 by major payers:
$2,981.09
$3,163.00
$3,285.84
$3,839.63
| 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 63101 | ||||||
United | 63101 | $555.00 | 1972030161 - ADVANCED VISION SURGERY CENTER LLC | 820697854 - (CO) ADVANCED VISION SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $700.00 | 1184316432 - PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $384.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $4893.00 | 1376790691 - MEMORIAL HERMANN ENDOSCOPY & SURGERY CENTER NORTH HOUSTON, LLC, NORTH HOUSTON ENDOSCOPY & SURGERY CENTER | 262809136 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $555.00 | 1326132291 - MADISON STREET SURGERY CENTER, LLC | 841499650 - (CO) MADISON STREET SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $616.00 | 1467833160 - AUSTELL SURGERY CENTER, LLC | 473077378 - (GA) AUSTELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $3348.22 | 1215904131 - NEBRASKA SURGERY CENTER LLC | 470812621 - (NE) NEBRASKA SURGERY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $874.00 | 1649676602 - MILE HIGH SURGERY CENTER, LLC | 830543458 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $900.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $364.00 | 1417190935 - MID-FLORIDA ENDOSCOPY & SURGERY CENTER LLC | 263388221 - (FL) MID-FLORIDA ENDOSCOPY & SURGER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $705.00 | 1548710775 - LINCOLN DIGESTIVE HEALTH CENTER LLC | 371833798 - (NE) LINCOLN DIGESTIVE HEALTH CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $600.00 | 1619920501 - CENTER FOR DIGESTIVE HEALTH | 364532301 - (IL) THE CENTER FOR DIGESTIVE HEALTH, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $758.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $443.00 | 1093214819 - PREMIER SURGICAL CENTER, LLC | 823438730 - (MS) PREMIER SURGICAL CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63101 | $700.00 | 1396141545 - AXIS SURGERY CENTER LLC | 463623155 - (GA) AXIS 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 63101 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63101 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 63101 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 |
|---|---|---|
| 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 |
| 63102-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); Lumbar, 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 63101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63101 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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