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See a sample rate comparisonCPT 63172 Fee Schedule
Last Verified: September 2026
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 Cyst On Spinal Cord, Surgery To Remove A Portion Of Vertebra (Spine) And To Drain A Fluid-Filled Sac (Cyst) On The Spinal Cord.
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 63172 |
| Medicaid Fee Schedule | View Medicaid rates for 63172 |
National average reimbursement for CPT 63172 by major payers:
$1,741.04
$1,899.76
$1,942.43
$2,262.74
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CPT 63172
5 of 25 sample ratesHigher to lower in this preview
Colorado Springs Surgicenter, LLC
Colorado Springs Surgicenter LLC
$2,785.00Published rateWilton Surgery Center LLC
$1,257.00Published rateVision Surgery & Laser Center, LLC
Vision Surgery Laser Center LLC
$734.00Published rateBaker Ambulatory Surgery Center
$545.00Published rateEndoscopy Associates Of Valley Forge, LLC
Endoscopy Associates Of Valley Forge LLC
$82.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 63170-CPT | High | Laminecto W/ Myelotomy (Eg Bischof Or Drez Typ) Cervcal Thora, Laminectomy With Myelotomy (Eg Bischof Or Drez Type) Cervical Thora |
| 63172-CPT | High | Drain Cyst On Spinal Cord, Surgery To Remove A Portion Of Vertebra (Spine) And To Drain A Fluid-Filled Sac (Cyst) On The Spinal Cord. |
| 63173-CPT | High | Drain Cyst On Spinal Cord, Surgery To Remove A Portion Of Vertebra (Spine) And To Drain A Fluid-Filled Sac (Cyst) On The Spinal Cord. |
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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