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CPT 63172 Fee Schedule

Last Verified: March 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 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
Medicare Fee ScheduleView Medicare rates for 63172

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$561.001255070116 - MERCY SOUTH ASC LLC, MERCY OUTPATIENT SURGERY CENTER - WEST BEND882512783MOAmbulatory 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$565.001114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$82.001376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1868.001619519535 - ANDERSON SURGERY CENTER LLC834200085 - (IL) ANDERSON SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1257.001972532539 - WILTON SURGERY CENTER LLC30496951 - (CT) WILTON SURGERY CENTER LLCCTAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1049.001962788059 - SURGCENTER OF SILVER SPRING, LLC452950933 - (MD) SURGCENTER OF SILVER SPRING LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$866.001225036601 - TALLGRASS SURGICAL CENTER, LLC481243206 - (KS) TALLGRASS SURGICAL CENTER, LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$550.001407206972 - HEART OF TEXAS SURGERY CENTER PLLC, WACO CENTER OF SURGICAL ARTS811843636 - (TX) HEART OF TEXAS SURGERY CENTER PLLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$500.001790265999 - MUVE822351627 - (PA) MUVEPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1887.001922365808 - GWINNETT ADVANCED SURGERY CENTER, LLC455067682GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$790.001811076623 - SPARTANBURG SURGERY CENTER, LLC570953005 - (SC) SPARTANBURG SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$784.001104993799 - SURGERY CENTER OF FORT COLLINS LLC841541559 - (CO) SURGERY CENTER OF FORT COLLINS, LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$680.001861702359 - INLAND OUTPATIENT SURGERY CENTER, INC.900621582CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63172$1407.001346468253 - FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC208335586 - (MN) FAIRVIEW MAPLE GROVE SURGERY CENTER LLCMNAmbulatory 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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