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CPT 63190 Fee Schedule

Last Verified: January 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.

Rhizotomy >2 Segments
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Nervous System

Common Place of Service

21 - Inpatient Hospital

24 - Ambulatory Surgical Center

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

AS - PA/NP/CNS assistant at surgery

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 63190

National average reimbursement for CPT 63190 by major payers:

bcbs

$1,609.96

uhc

$1,714.31

aetna

$1,830.53

cigna

$2,099.77

Preview provider-level rates for...
For billing codeCPT 63190
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 63190

United
63190$4128.001790742328 - SPRINGHILL SURGERY CENTER, LLC621712554 - (AR) SPRINGHILL SURGERY CENTER, LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$10073.001275231466 - ADVANCED JOINT AND SPINE INSTITUTE-ORLANDO, LLC872644888FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$3597.001770570467 - DELAWARE EYE SURGERY CENTER, LLC510412455DEAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$11924.001982360780 - SMARTCARE PALM HARBOR, LLC853980592 - (FL) SMARTCARE PALM HARBOR LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$5699.001922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$2400.001659377042 - TOMS RIVER AMBULATORY SURGICAL CENTER, BEY LEA AMBULATORY SURGICAL CENTER223802381 - (NJ) TOMS RIVER AMBULATORY SURGICAL CENTERNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$8757.001326097981 - FREDERICKSBURG AMBULATORY SURGERY CENTER, LLC562322548 - (VA) FREDERICKSBURG AMBULATORY SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$3343.001457725392 - THE ENDOSCOPY CENTER OF QUEENS INC262427823 - (NY) THE ENDOSCOPY CENTER OF QUEENS INCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$7910.001750612446 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF GLEN BURNIE271271303 - (MD) BAY SURGERY CENTERSMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$12834.001336538297 - MINNETONKA AMBULATORY SURGERY CENTER LLC465653486 - (MN) MINNETONKA AMBULATORY SURGERY CENTER LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$5375.001750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER364701304 - (TX) VIVERE HEALTH DALLAS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$9088.001316939556 - SEQUOIA SURGICAL CENTER LP, SEQUOIA SURGICAL PAVILION364408212 - (CA) SEQUOIA SURGICAL CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$4500.001770907172 - EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLC462875016 - (NJ) EYE AND LASER SURGERY CENTERS OF NEW JERSEY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$668.001184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
63190$4878.001346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY 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 63190 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 63190 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 63190 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
63185-CPTHighRhizotomy <2 Segments
63190-CPTHighRhizotomy >2 Segments
63191-CPTHighSection Spinal Accessory Nerve Unil

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 63190 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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