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CPT 63172 Fee Schedule

Last Verified: November 2025

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.

Drain Spinal Cyst To Subarachnoid
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Nervous System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

19 - Off Campus Outpatient Hospital

Common Modifiers

None

AS - PA/NP/CNS assistant at surgery

51 - Multiple procedures

Complexity LevelHigh

National average reimbursement for CPT 63172 by major payers:

bcbs

$1,741.04

uhc

$1,899.76

aetna

$1,942.43

cigna

$2,322.10

Preview provider-level rates for...
For billing codeCPT 63172
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 63172

United
63172$983.001396174454 - SURGERY CENTER OF SCOTTSDALE LLC731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$3348.221609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1275.001134665193 - NHPE, LLC, NEW HYDE PARK ENDOSCOPY471158058NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1400.001851407399 - SOUTHERN NEW MEXICO SURGERY CENTER, LLC201826172 - (NM) SOUTHERN NEW MEXICO SURGERY CENTERNMAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$862.001396709077 - RMC SURGERY CENTER, LLC, RMC SURGERY CENTER330937423CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$500.001790265999 - MUVE822351627 - (PA) MUVEPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$565.001114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$983.001841251501 - ST AUGUSTINE ENDOSCOPY CENTER LLC592947745 - (FL) ST AUGUSTINE ENDOSCOPY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1274.001891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY611917634 - (FL) ADVANCED CENTER FOR SURGERYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$475.001497723720 - JACKSONVILLE BEACH SURGERY CENTER, LLC, JACKSONVILLE BEACH SURGERY CENTER621825684 - (FL) JACKSONVILLE BEACH SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1868.001619519535 - ANDERSON SURGERY CENTER LLC834200085 - (IL) ANDERSON SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$283.001275513806 - PINNACLE CATARACT AND LASER INSTITUTE LLC743117000 - (WI) PINNACLE CATARACT AND LASER INSTITUTE LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$545.001053301473 - BAKER AMBULATORY SURGERY CENTER710839283 - (AR) BAKER AMBULATORY SURGERY CENTERARAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$2500.001659335438 - RESTON SURGERY CENTER, LP113654617 - (VA) RESTON SURGERY CENTER LPVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$810.001457976383 - VHC-I851094630 - (AZ) VHCIAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 63172 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 63172 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 63172 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.

CodeComplexityDescription
63170-CPTHighLaminectomy W Myelotomy;Cerv,Thoracic,Th
63172-CPTHighDrain Spinal Cyst To Subarachnoid
63173-CPTHighLaminectomy W Drainage Cyst;To Peritonea

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63172. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 63172 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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