CPT 63064 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 63064 by major payers:
$2,117.37
$2,437.66
$2,507.28
$2,943.42
| 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 63064 | ||||||
United | 63064 | $5100.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $1190.00 | 1376513440 - FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $1020.00 | 1619166097 - GPDDC, LLC | 43769350 - (NY) GPDDC, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $14865.00 | 1619333010 - ORANGE ASC, LTD, ORTHOPEDIC ONE SURGERY CENTER AT EASTON | 464700223 - (OH) ORANGE ASC LTD DBA ORTHOPEDIC ONE SURGERY CENTER AT EASTON | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $1934.00 | 1780699546 - CASCADES ENDOSCOPY CENTER, LLC, WHITEMARSH ENDOSCOPY CENTER | 203496335 - (MD) CASCADES ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $4950.00 | 1740891571 - PENINSULA SURGERY CENTER, LLC | 842769083 - (CA) PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $2534.00 | 1396782553 - SSM ST. JOSEPH SURGERY CENTER, LLC, THE SURGERY CENTER AT ST. JOSEPH MEDICAL PARK | 431822767 - (MO) SSM ST JOSEPH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $3250.00 | 1962869826 - ENDOTECH, LLC | 472926864 - (AZ) ENDOTECH LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $901.00 | 1467010736 - MERCY SURGERY CENTER LLC | 841875159 - (IA) MERCY SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $1305.00 | 1235117052 - ALLEGANY AMBULATORY SURGERY CENTER LLC | 522268598 - (MD) ALLEGANY AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $1306.00 | 1720215320 - EAST SIDE ENDOSCOPY LLC | 263006590 - (NY) EAST SIDE ENDOSCOPY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $2999.38 | 1548445927 - GEORGE GANDEV | 350593390 - DEACONESS HOSPITAL INC | IN | Pulmonary Disease Physician (207RP1001X) |
United | 63064 | $2999.38 | 1417396094 - ENRIQUE CAMPOS | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 63064 | $6657.00 | 1184900102 - METROPOLITAN NEW JERSEY, LLC, METROPOLITAN SURGERY CENTER | 453003521 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 63064 | $6876.00 | 1568884104 - EMORY AMBULATORY SURGERY CENTER AT DUNWOODY, LLC | 464115055 - (GA) EMORY AMBULATORY SURGERY CENTER AT DUNWOODY LLC | GA | 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 63064 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 63064 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 63064 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 |
|---|---|---|
| 63057-CPT | Moderate | Transpedicular Approach With Decompression Of Spinal Cord, Equina And/Or Nerve Root(S) (Eg, Herniated Intervertebral Disc), Single Segment; Each Additional Segment, Thoracic Or Lumbar (List Separately In Addition To Code For Primary Procedure) |
| 63064-CPT | High | Costovertebral Approach With Decompression Of Spinal Cord Or Nerve Root(S) (Eg, Herniated Intervertebral Disc), Thoracic; Single Segment |
| 63066-CPT | Moderate | Costovertebral Approach With Decompression Of Spinal Cord Or Nerve Root(S) (Eg, Herniated Intervertebral Disc), Thoracic; Each Additional Segment (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 63064. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 63064 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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