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See a sample rate comparisonCPT 63200 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.
Remove Scar Tissue On Spine, Removal Of A Portion Of Vertebra (Spine) And Surgery To Remove Adhesions (Scar Tissue) 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 |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63200 |
| Medicaid Fee Schedule | View Medicaid rates for 63200 |
National average reimbursement for CPT 63200 by major payers:
$1,961.33
$2,075.10
$2,230.07
$2,456.45
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CPT 63200
5 of 25 sample ratesHigher to lower in this preview
Delray Beach Surgical Suites, LLC
Delray Beach Surgical Suites LLC
$13,382.00Published rateSurgery Center Of Lynchburg LLC
$6,352.00Published rateFirst Gi Endoscopy And Surgery Center LLC
$4,266.00Published rateSurgeyecare, Inc., Surgeyecare General Partnership
$3,296.00Published rateSouthern Ohio Eye Surgery Center, LLC
Southern Ohio Eye Surgery Center LLC
$1,075.00Published rate
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See a sample payer proposalCPT 63200 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63200 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 63200 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 |
|---|---|---|
| 63197-CPT | High | Surgery On The Spinal Nerves, Surgery To Remove One Or More Bones Of The Spine (Vertebrae) And Disable Nerves In The Spinal Cord That Transmit Pain Signals To The Brain. |
| 63200-CPT | High | Remove Scar Tissue On Spine, Removal Of A Portion Of Vertebra (Spine) And Surgery To Remove Adhesions (Scar Tissue) On The Spinal Cord. |
| 63250-CPT | High | Surgery On Spine Blood Vessels, Surgery On The Spine In Order To Repair An Artery And Vein That Have Formed Improperly. The Procedure Requires Removing A Portion Of A Spine Bone (Vertebra). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63200 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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