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See a sample rate comparisonCPT 63251 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 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).
| 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 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 63251 |
| Medicaid Fee Schedule | View Medicaid rates for 63251 |
National average reimbursement for CPT 63251 by major payers:
$3,804.04
$4,143.80
$4,190.79
$4,832.19
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CPT 63251
5 of 25 sample ratesHigher to lower in this preview
Eagle Highlands Surgery Center LLC, Eagle Highlands Surgery Center
$7,400.00Published ratePiedmont Asc LLC
$1,167.00Published rateThe Outpatient Center, LLC, The Outpatient Center Of Boynton Beach, Ltd.
The Outpatient Center Of Boynton Beach, Ltd.
$983.00Published rateAmbulatory Care Center PA
$473.00Published rateAtlantic Plastic Surgery Associates PA
Atlantic Plastic Surgery Associates, P.A.
$185.00Published rate
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See a sample payer proposalCPT 63251 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63251 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 63251 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 |
|---|---|---|
| 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). |
| 63251-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). |
| 63252-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 63251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63251 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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