CPT 63304 Fee Schedule
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.
| 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 • 22 - Increased Procedural Services • 62 - Co-Surgeons • 79 - Unrelated procedure - postop period • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 63304 by major payers:
$2,921.14
$3,174.95
$3,247.49
$3,831.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 63304 | ||||||
United | 63304 | $498.00 | 1407992878 - WILSON COUNTY EYE SURGERY CENTER, LLC | 621714950 - (TN) WILSON COUNTY EYE SURGERY CENTER, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $441.00 | 1528340213 - UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC | 453017917 - (NJ) UNIVERSITY CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $2705.00 | 1649233180 - WEST PARK SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/MCKINNEY | 800002697 - (TX) WEST PARK SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $1579.00 | 1932162195 - COVENANT HIGH PLAINS SURGERY CENTER, LLC, COVENANT HIGH PLAINS SURGERY CENTER - QUAKER AVENUE | 752177401 - (TX) COVENANT HIGH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $1049.00 | 1831180272 - ADVANCED ENDOSCOPY CENTER LLC | 861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $775.00 | 1285889378 - PARADIGM CLINICAL ASSOCIATES LLC, STRATHAM AMBULATORY SURGERY CENTER | 262382365 - (NH) PARADIGM CLINICAL ASSOCIATES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $435.00 | 1972179208 - IDAHO OTOLOGIC SURGERY CENTER, LLC, SYRINGA OUTPATIENT SURGERY CENTER | 852522925 - (ID) IDAHO OTOLOGIC SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $1881.00 | 1700966710 - SURGERY CENTER OF KALAMAZOO LLC | 61694249 - (MI) SURGERY CENTER OF KALAMAZOO LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $1128.00 | 1700502150 - MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | 883714959 - (SC) MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $350.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $640.00 | 1740442615 - CENTER FOR ADVANCED REPRODUCTIVE SERVICES, PC, AMBULATORY SURGICAL CENTER AT REPRODUCTIVE SERVICES | 61522659 - (CT) CENTER FOR ADVANCED REPRODUCTIVE SERVICES, P.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $1064.00 | 1275682627 - SUMMIT VIEW SURGERY CENTER, LLC | 20659552 - (CO) SUMMIT VIEW SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $912.00 | 1588328918 - HARLEM ROAD AMBULATORY SURGERY CENTER LLC | 833648797 - (NY) HARLEM ROAD AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $300.00 | 1306964853 - GASTROENTEROLOGY ENDOSCOPY CENTER | 582349040 - (GA) GASTROENTEROLOGY ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63304 | $750.00 | 1376501064 - SOUTH CENTRAL SURGICAL CENTER, LLC, CENTER FOR SPECIALTY CARE | 411952256 - (MN) SOUTH CENTRAL SURGICAL CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 63304 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63304 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 63304 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 |
|---|---|---|
| 63270-CPT | High | Lamin-Exc Intrasp.Les,Intradur;Cerv |
| 63280-CPT | High | Lam,Bx/Exc Int.Neo;Intra,Extra,Cerv |
| 63285-CPT | High | Lam,Bx/Exc In.Neo;Intradur,Im,Cerv |
| 63304-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, For Excision Of Intraspinal Lesion, Single Segment; Intradural, Cervical |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63304 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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