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CPT 63251 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.

Lam-Exc/Occl.Art.Malfor.Cord;Thorac
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

AS - PA/NP/CNS assistant at surgery

80 - Assistant surgeon

Complexity LevelHigh

National average reimbursement for CPT 63251 by major payers:

bcbs

$3,804.04

uhc

$4,143.80

aetna

$4,190.79

cigna

$4,959.97

Preview provider-level rates for...
For billing codeCPT 63251
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 63251

United
63251$590.001225096134 - GAINESVILLE EYE CENTER, LLC201895224 - (GA) GAINESVILLE EYE CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$2172.001992037352 - BAYLOR SURGICARE AT MANSFIELD, LLC, BAYLOR SCOTT & WHITE SURGICARE - MANSFIELD271835675TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$694.001073009304 - SUSITNA SURGERY CENTER LLC472934701 - (AK) SUSITNA SURGERY CENTER LLCAKAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$624.001538336219 - PACIFIC CATARACT AND LASER INSTITUTE INC PC911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$1064.001821036138 - GAMMA SURGERY CENTER LLC270128900 - (PA) GAMMA SURGERY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$983.001811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD.650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$730.001770019200 - GEORGIA CATARACT AND EYE SPECIALTY CENTER LLC, GEORGIA CATARACT AND EYE SPECIALTY CENTER461115901 - (GA) GEORGIA CATARACT AND EYE SPECIALTY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$251.001578505079 - TRUXTUN SURGERY CENTER INC770414100 - (CA) TRUXTUN SURGERY CENTER, INC.CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$445.001477500767 - SOUTHPOINT SURGERY CENTER, LLC203579196 - (FL) SOUTHPOINT SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$1167.001740673953 - MANCHESTER AMBULATORY SURGERY CENTER LP, DES PERES SQUARE SURGERY CENTER205953313MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$4893.001033586136 - PHYSICIANS WEST HOUSTON SURGICAL CENTER, LLC, MEMORIAL HERMANN SURGERY CENTER PARK TEN371789833TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$445.001538411145 - DIGESTIVE HEALTH SPECIALISTS, PA561242980 - (NC) DIGESTIVE HEALTH SPECIALISTS, P.A.NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$430.001770588584 - PHYSICIANS SURGERY CENTER LLC, NATIONAL SPINE & ORTHO SURGERY CENTER OF FT. MYERS592924183 - (FL) PHYSICIANS SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$580.001497740617 - LAKE COUNTY PAIN & DIAGNOSTIC651216636 - (OH) LAKE COUNTY PAIN DIAGNOSTICOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
63251$524.001336112200 - MERCER COUNTY SURGERY CENTER LLC, MERCER COUNTY SURGERY CENTER223774069 - (NJ) MERCER COUNTY SURGERY 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 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.

CodeComplexityDescription
63250-CPTHighExc Av Les Sp Cord Cervical
63251-CPTHighLam-Exc/Occl.Art.Malfor.Cord;Thorac
63252-CPTHighExc Av Les Sp Cord Thoracolumbar

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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