What is the standard insurance baseline for CPT 61863?

The standard insurance baseline reimbursement rate is $1596.68. This represents the customary allowable amount established across standard fee schedules.

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CPT 61863Medical Service

Removal of Skull Bone with Computer-assisted Insertion of Neurostimulator Electrodes in Brain

Q: What do doctors typically charge for Removal of Skull Bone with Computer-assisted Insertion of Neurostimulator Electrodes in Brain?

The nationwide median physician charge for Removal of Skull Bone with Computer-assisted Insertion of Neurostimulator Electrodes in Brain (CPT 61863) is $6076.50. Doctor billed charges vary based on geographic region, setting, and overhead.

Removal of skull bone with computer-assisted insertion of neurostimulator electrodes in brain, first array. Clinical pricing breakdown and utilization metrics across 26 practicing doctors nationwide.

$6076.50

Peer Median Charge

Gross billed rate

$1596.68

Standard Baseline

Customary allowable

3.8x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $6076.50. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $1596.68 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 61863 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"