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See a sample rate comparisonCPT 63190 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.
Surgery To Cut Spinal Nerves, Surgery To Remove One Or More Bones Of The Spine (Vertebrae) And Sever Nerves In The Spinal Cord. This Procedure Relieves Muscle Spasm And Pain.
| Key Fact | Detail |
|---|---|
| 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 Level | High |
| Medicare Fee Schedule | View Medicare rates for 63190 |
| Medicaid Fee Schedule | View Medicaid rates for 63190 |
National average reimbursement for CPT 63190 by major payers:
$1,609.96
$1,714.31
$1,830.53
$2,053.82
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CPT 63190
5 of 25 sample ratesHigher to lower in this preview
Minnetonka Ambulatory Surgery Center LLC
$12,834.00Published rateSequoia Surgical Center Lp, Sequoia Surgical Pavilion
Sequoia Surgical Center Lp
$9,088.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$6,497.00Published rateEye And Laser Surgery Centers Of New Jersey LLC
$4,500.00Published rateLong Island Center For Digestive Health LLC
Long Island Center For Digestive Health, LLC
$668.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 63185-CPT | High | Surgery To Cut Spinal Nerves, Surgery To Remove One Or More Bones Of The Spine (Vertebrae) And Sever Nerves In The Spinal Cord. This Procedure Relieves Muscle Spasm And Pain. |
| 63190-CPT | High | Surgery To Cut Spinal Nerves, Surgery To Remove One Or More Bones Of The Spine (Vertebrae) And Sever Nerves In The Spinal Cord. This Procedure Relieves Muscle Spasm And Pain. |
| 63191-CPT | High | Surgery To Cut Spinal Nerves, Surgery To Remove One Or More Bones Of The Spine (Vertebrae) And Sever Nerves In The Spinal Cord. This Procedure Relieves Muscle Spasm And Pain. |
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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