CPT 63709 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 78 - Return to OR - related procedure • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 63709 by major payers:
$1,353.81
$1,508.46
$1,585.72
$1,851.05
| 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 63709 | ||||||
United | 63709 | $382.00 | 1053685677 - ARKANSAS CENTER FOR SURGICAL EXCELLENCE | 454640707 - (AR) ARKANSAS CENTER FOR SURGICAL EXCELLENCE | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $412.00 | 1952602609 - GASTROENTEROLOGY & HEPATOLOGY CONSULTANTS, PA, WAKE FOREST ENDOSCOPY CENTER | 562189630 - (NC) GASTROENTEROLOGY AND HEPATOLOGY CONSULTANTS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $22500.00 | 1740337435 - DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER, DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER | 342064423 - (CA) DIAGNOSTIC AND INTERVENTIONAL SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $1169.00 | 1861743601 - FLUSHING ENDOSCOPY CENTER, LLC | 274675522 - (NY) FLUSHING ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $100.00 | 1659683662 - PREMIER ENDOSCOPY CENTER, LLC | 272932575 - (AZ) PREMIER ENDOSCOPY CENTER, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $1064.00 | 1831525112 - LONGLEAF SURGERY CENTER, LLC | 462421622 - (FL) LONGLEAF SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $1274.00 | 1992796742 - SAN ANTONIO ENDOSCOPY, LP, SAN ANTONIO ENDOSCOPY CENTER | 202511329 - (TX) SAN ANTONIO ENDOSCOPY LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $2775.00 | 1902401748 - LANDMARK SURGICAL SUITES, LLC | 851130696 - (IN) LANDMARK SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $592.00 | 1801844386 - SOUTHEASTERN UROLOGICAL PARTNERS LTD, SOUTHEASTERN SURGERY CENTER | 593470900 - (FL) SOUTHEASTERN UROLOGICAL PARTNERS, LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $546.00 | 1962463133 - SURGICAL CENTERS OF MICHIGAN, LLC. | 383580697 - (MI) SURGICAL CENTERS OF MICHIGAN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $922.00 | 1023734084 - WEST GEORGIA SURGERY CENTER, LLC | 833671516 - (GA) TANNER MEDICAL CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $2037.00 | 1528521887 - NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY, LLC | 825250651 - (NC) NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $1050.00 | 1043297872 - CENTRAL JERSEY AMBULATORY SURGICAL CENTER, LLC | 223669777 - (NJ) CENTRAL JERSEY AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $430.00 | 1346386604 - DIGESTIVE HEALTH CENTER LLC | 341955920 - DIGESTIVE HEALTH CENTER, LTD. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63709 | $970.00 | 1093461410 - INFIRMARY ASC | 871933440 - (AL) INFIRMARY ASC | AL | 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 63709 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63709 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 63709 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 |
|---|---|---|
| 63287-CPT | High | Lam,Bx/Exc Neo;Intradur,Im,Thoracol |
| 63305-CPT | High | Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, For Excision Of Intraspinal Lesion, Single Segment; Intradural, Thoracic By Transthoracic Approach |
| 63707-CPT | High | Repair Dural/Csf Leak/Pseudomeningocele, |
| 63709-CPT | High | Repr Dural/Csf Leak/Pseudomen,Lamin |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 63709. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63709 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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