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See a sample rate comparisonCPT 0164T Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Remove Lumb Artif Disc Addl, Removal Of Total Disc Arthroplasty Artificial Disc Anterior Approach Each Additional Interspace Lumbar List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Category III Codes Various Services - Category III Codes |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0164T |
| Medicaid Fee Schedule | View Medicaid rates for 0164T |
National average reimbursement for CPT 0164T by major payers:
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CPT 0164T
5 of 25 sample ratesHigher to lower in this preview
Mission Hospital, Inc., Mission Regional Medical Center
Mission Hospital Inc
$5,442.00Published rateFort Worth Surgicare Partners, Ltd., Baylor Scott & White Surgical Hospital - Fort Worth
Fort Worth Surgicare Partners Ltd
$1,745.00Published rateNorth Houston, Hca Houston Healthcare Tomball
$1,475.00Published rateTexas Health Presbyterian Hospital Allen
$1,181.00Published rateImperial Calcasieu Surgical Center LLC, Christus Imperial Calcasieu Surgical Center
Imperial Calcasieu Surgical Center LLC
$137.00Published rate
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See a sample payer proposalCPT 0164T vs. Other Various Services - Category III Codes Codes
The CPT 0164T code is part of the Category III Codes services used for Various Services - Category III Codes. 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 0164T 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 |
|---|---|---|
| 0164T-CPT | Moderate | Remove Lumb Artif Disc Addl, Removal Of Total Disc Arthroplasty Artificial Disc Anterior Approach Each Additional Interspace Lumbar List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0164T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0164T 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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