CPT 63655 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • SG - Scene to Hospital ESRD facility |
| Complexity Level | High |
National average reimbursement for CPT 63655 by major payers:
$1,077.08
$1,134.55
$1,207.86
$1,410.84
| 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 63655 | ||||||
United | 63655 | $18125.00 | 1841782539 - MILE HIGH SURGICENTER, LLC | 830543458 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $1727.00 | 1588638688 - MASONICARE HEALTH CENTER | 60655131 - (CT) MASONICARE HEALTH CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $1723.00 | 1518955897 - BONITA COMMUNITY HEALTH CENTER INC, BONITA SPRINGS HEALTH CENTER | 593544102 - (FL) BONITA COMMUNITY HEALTH CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $10000.00 | 1639701980 - ORTHOPAEDIC SURGERY CENTER OF PANTHER CREEK LLC | 843730735 - (NC) ORTHOPAEDIC SURGERY CENTER OF PANTHER CREEK LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $7920.00 | 1962059915 - BRIGHTSIDE SURGICAL, LLC | 831888619 - (ND) BRIGHTSIDE SURGICAL LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $8384.00 | 1912158684 - SURGCENTER OF BEL AIR | 262215322 - (MD) SURGCENTER OF BEL AIR, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $8405.00 | 1952516684 - POTTSTOWN HOSPITAL COMPANY LLC, POTTSTOWN MEMEORIAL MEDICAL CENTER | 822132538 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $3362.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $9324.00 | 1952749491 - HAYMARKET SURGERY CENTER, LLC | 462874962 - (VA) HAYMARKET SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $4456.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $8917.00 | 1730713439 - FLORIDA SPRINGS SURGERY CENTER LLC | 832895293 - (FL) FLORIDA SPRINGS SURGERY CENTER L | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $2218.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $3000.00 | 1205221470 - NEWSOM SURGERY CENTER OF SEBRING LLC | 472439597 - (FL) NEWSOM SURGERY CENTER OF SEBRING LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $5500.00 | 1659451078 - ACADEMY ORTHOPEDICS, LLC, DBA ACADEMY ORTHOPEDICS, LLC, AMBULATORY SURGICAL CENTER | 582383939 - (GA) ACADEMY ORTHOPEDICS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63655 | $7957.00 | 1982873352 - BAHAMAS SURGERY CENTER LLC | 208025178 - (CA) BAHAMAS SURGERY CENTER LLC | CA | 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 63655 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63655 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 63655 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 |
|---|---|---|
| 63650-CPT | High | Percut.Impl-Neurostm.Electrod;Epidu |
| 63655-CPT | High | Lam-Impl-Neurostim.Electrod;Epidurl |
| 63661-CPT | Moderate | Once Per Dos Removal Of Spinal Neurostimulator Electrode Percutaneous Array(S), Including Fluoroscopy, When Performed- Rn Review=1/1/2010 - 11/28/2018 |
| 63662-CPT | High | Once Per Dos Removal Of Spinal Neurostimulator Electrode Plate/Paddle(S) Placed Via Laminotomy Or Laminectomy, Including Fluoroscopy, When Performed- Rn Review=1/1/10-11/28/18 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63655. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63655 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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