CPT 63103 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 • 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 | Moderate |
National average reimbursement for CPT 63103 by major payers:
$374.41
$404.04
$422.64
$483.11
| 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 63103 | ||||||
United | 63103 | $469.00 | 1912196494 - VALDOSTA FOOT & ANKLE SURGERY CENTER, P.C. | 582556232 - (GA) VALDOSTA FOOT ANKLE SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $1064.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $850.00 | 1376605279 - MIDWEST CENTER FOR DAY SURGERY, LLC | 208103522 - (IL) MIDWEST CENTER FOR DAY SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $1954.00 | 1437764321 - BAPTIST HEALTH SURGERY CENTER, LLC, BAPTIST HEALTH SURGERY CENTER AT PLANTATION | 650663357 - (FL) BAPTIST HEALTH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $1049.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $940.00 | 1922334101 - ORTHOPEDIC SURGERY CENTER OF GREEN BAY, LLC | 264677834 - (WI) ORTHOPEDIC SURGERY CENTER OF GREEN BAY | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $607.00 | 1750905618 - RSPS FAYETTEVILLE ASC LLC, RSPS FAYETTEVILLE ASC | 851271440 - (GA) RSPS FAYETTEVILLE ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $450.00 | 1275642480 - EGNM LLC, LEWES SURGERY CENTER | 510411737 - (DE) EGNM, LLC DBA LEWES SURGERY CENTER | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $384.00 | 1457784852 - SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC, CLEARWAY SURGERY CENTER OF OWINGS MILLS | 454995677 - (MD) SMART PAIN SURGERY CENTER AT OWINGS MILLS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $150.00 | 1508054818 - CUMMINS WOMENS HEALTHCARE LLC, ELIZABETH CUMMINS MD | 522110421 - (OH) CUMMINS WOMENS HEALTHCARE, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $273.00 | 1710591060 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC | 272910652 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $600.00 | 1003166844 - PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | 455218356 - (TX) PSA AMBULATORY SURGERY CENTER OF KILLEEN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $1188.00 | 1801899687 - TRINITY SURGERY CENTER LLC, BAYCARE SURGERY CENTER | 20656933 - (FL) TRINITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $442.00 | 1346416690 - GARDEN STATE AMBULATORY SURGERY CENTER PC | 223504597 - (NJ) GARDEN STATE AMBULATORY SURGERY CENTER PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63103 | $519.00 | 1063584415 - CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA, CAROLINA DIGESTIVE ENDOSCOPY CENTER | 561335864 - (NC) CAROLINA DIGESTIVE HEALTH ASSOCIATES, PA | NC | 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 63103 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63103 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 63103 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 |
|---|---|---|
| 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 |
| 63103-CPT | Moderate | 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 Ragments); Thoracic Or Lumbar Each Additional Segment (List Separately In Addition To Code For Primary Procedure) |
| 63170-CPT | High | Laminectomy W Myelotomy;Cerv,Thoracic,Th |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63103. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63103 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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