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CPT 63185 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.

Rhizotomy <2 Segments
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Nervous System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

51 - Multiple procedures

59 - Distinct Procedural Service

Complexity LevelHigh

National average reimbursement for CPT 63185 by major payers:

bcbs

$1,456.59

uhc

$1,564.52

aetna

$1,603.63

cigna

$1,948.11

Preview provider-level rates for...
For billing codeCPT 63185
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 63185

United
63185$9510.001366684326 - PRINCE FREDERICK SURGERY CENTER LLC264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$11180.001114264488 - EXECUTIVE SURGERY CENTER, LLC300701899 - (TX) EXECUTIVE SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$13928.001609052679 - BELTWAY SURGERY CENTERS, LLC, BELTWAY SURGERY CENTER SPRINGMILL352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$8000.001396454963 - ST LUKES SURGICAL CENTER INC, ST. LUKE'S SURGICAL AT WESLEY CHAPEL592407224 - (FL) ST LUKES SURGICAL CENTER INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$550.001689035537 - YUMA ENDOSCOPY CENTER473656580 - (AZ) YUMA ENDOSCOPY CENTER, LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$1148.001386277069 - SOUTHWEST ENDOSCOPY LLC261261804AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$1500.001841672615 - ALLIANCE SURGERY CENTER AT AUGUSTA, LLC474382081 - (GA) ALLIANCE SURGERY CENTER AT AUGUSTA LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$7528.001457709289 - GENESYS SURGERY CENTER LLC810774180 - (MI) GENESYS SURGERY CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$7454.001104341353 - BANNER PEORIA SURGERY CENTER LLC901182685 - (AZ) BANNER PEORIA SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$9000.001265964050 - SCHAUMBURG SURGERY CENTER, LLC813061805 - (IL) SCHAUMBURG SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$1050.001588665269 - RF EYE PC, COCHISE EYE & LASER ASC860879991 - (AZ) R.F. EYE, PCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$25750.001528653037 - BASALT ORTHOPEDIC SURGERY CENTER, LLC, BOSC844161898 - (CO) BASALT ORTHOPEDIC SURGERY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$4000.001275522849 - COLIMA ENDOSCOPY CENTER INC, COLIMA ENDOSCOPY CENTER954611492 - (CA) COLIMA ENDOSCOPY CENTER, INC.CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$5175.001255309951 - BAYFRONT SAME DAY SURGERY CENTER, LLC.845074208 - (FL) OHI WEST INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63185$1702.001578525283 - PRINCETON ENDOSCOPY CENTER LLC200445094 - (NJ) PRINCETON ENDOSCOPY CENTER LLCNJAmbulatory 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 63185 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 63185 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 63185 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
63173-CPTHighLaminectomy W Drainage Cyst;To Peritonea
63185-CPTHighRhizotomy <2 Segments
63190-CPTHighRhizotomy >2 Segments

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63185. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 63185 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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