CPT 0164T Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Category III Codes • Various Services - Category III Codes |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0164T |
National average reimbursement for CPT 0164T by major payers:
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| 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 0164T | ||||||
United | 0164T | $1824.00 | 1679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $531.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 0164T | $1571.00 | 1235510090 - HERITAGE PARK SURGICAL HOSPITAL LLC, BAYLOR SCOTT & WHITE SURGICAL HOSPITAL AT SHERMAN | 611762781 | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $1547.00 | 1376256354 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL HILL COUNTRY | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $1190.00 | 1295764330 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS, MEMORIAL HERMANN BAPTIST ORANGE HOSPITAL | 741303720 - BAPTIST HOSPITALS OF SOUTHEAST TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $3432.00 | 1477500015 - RAPIDES HEALTHCARE SYSTEM, L.L.C., RAPIDES REGIONAL MEDICAL CENTER | 611267229 | LA | General Acute Care Hospital (282N00000X) |
United | 0164T | $1415.00 | 1134166192 - ORTHOPEDIC HOSPITAL LTD, TEXAS ORTHOPEDIC HOSPITAL | 760418502 - (TX) ORTHOPEDIC HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $1178.00 | 1467448498 - AIKEN REGIONAL MEDICAL CENTERS LLC, AIKEN REGIONAL MEDICAL CENTER | 232791808 | SC | General Acute Care Hospital (282N00000X) |
United | 0164T | $5442.00 | 1205833985 - MISSION HOSPITAL, INC., MISSION REGIONAL MEDICAL CENTER | 742206635 - (TX) MISSION HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $2749.00 | 1659559573 - ST LUKES COMMUNITY DEVELOPMENT CORPORATION, ST LUKES SUGAR LAND HOSPITAL | 261947374 - (TX) ST LUKES COMMUNITY DEVELOPMENT CORPORATION-SUGAR LAND | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $555.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 0164T | $1475.00 | 1750819025 - NORTH HOUSTON, HCA HOUSTON HEALTHCARE TOMBALL | 50631189 | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $1475.00 | 1831112895 - HOUSTON NORTHWEST PARTNERS, LTD., HOUSTON NORTHWEST MEDICAL CENTER | 261512163 | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $2500.00 | 1992707228 - SHANNON MEDICAL CENTER | 752559845 - (TX) SHANNON MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 0164T | $1484.00 | 1396854543 - LIFECARE HOSPITAL OF NEW ORLEANS AT KENNER | 205432782 | LA | General Acute Care Hospital (282N00000X) |
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 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 | 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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