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CPT 63704 Fee Schedule

Last Verified: January 2026

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.

Repair Myelomeningocele; Under 5 Cm Diam
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Nervous System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

62 - Co-Surgeons

80 - Assistant surgeon

Complexity LevelHigh

National average reimbursement for CPT 63704 by major payers:

bcbs

$2,043.76

uhc

$2,211.99

aetna

$2,262.66

cigna

$2,704.32

Preview provider-level rates for...
For billing codeCPT 63704
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 63704

United
63704$1049.001144331760 - RESURGENS SURGERY CENTER LLC582397841 - (GA) RESURGENS SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$1049.001740778554 - ORO VALLEY SURGICAL SUITES LLC823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$372.001033113402 - NORTHWEST FLORIDA SURGICAL CENTER, LLC, NORTH FLORIDA SURGERY CENTER593081991 - (FL) NORTHWEST FLORIDA SURGICAL CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$421.001033294640 - NORTHERN NEW JERSEY EYE INSTITUTE PA222489176 - (NJ) NORTHERN NEW JERSEY EYE INSTITUTE, P.A.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$983.001861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$100.001902958226 - AMBULATORY SURGERY CENTER OF TUCSON, INC.262420656 - (AZ) AMBULATORY SURGERY CENTER OF TUCSON INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$291.001083669196 - SPECIALTY ASC LLC, SURGICAL ARTS CENTER880503205 - (NV) SPECIALTY ASC LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$758.001780618801 - PINEY ORCHARD SURGERY CENTER, LLC.521938770 - (MD) PINEY ORCHARD SURGERY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$2732.001093459315 - PERFORMANCE HEALTH SURGICENTER, LLC881897351 - (FL) PERFORMANCE HEALTH SURGICENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$750.001376884585 - ADVANCED UROLOGY SURGERY CENTER461456287 - (GA) ADVANCED UROLOGY SURGERY CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$2584.001780853044 - HACIENDA SURGERY CENTER, LLC320439356CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$271.001700263415 - NORTH POINT SURGERY CENTER, LLC464488421 - (MO) NORTH POINT SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$1124.001275158495 - BCC CHANDLER LLC851284830 - (AZ) BCC CHANDLER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$1049.001881905792 - SURGCENTER PINELLAS, LLC271372259 - (FL) SURGCENTER PINELLAS, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
63704$461.001225297138 - WEST NORMAN ENDOSCOPY CENTER, LLC736048282OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 63704 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 63704 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 63704 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.

CodeComplexityDescription
63700-CPTHighRepair Meningocele; Less Than 5 Cm. Diam
63704-CPTHighRepair Myelomeningocele; Under 5 Cm Diam
63706-CPTHighRepair Myelomeningocele >5cm
63709-CPTHighRepr 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 63704. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 63704 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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