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See a sample rate comparisonHealthcare 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 | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 50 - Bilateral Procedure 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64400 |
| Medicaid Fee Schedule | View Medicaid rates for 64400 |
National average reimbursement for CPT 64400 by major payers:

$144.24

$152.90

$172.39

$189.44
Choose a payer to see a sample of rates for CPT 64400.
North Shore Same Day Surgery LLC
North Kitsap Ambulatory Center, Inc. Dba Pacific Surgery Center
Bonita Community Health Center
Doctors Surgery Center PA
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 64400 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64400 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 64400 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 |
|---|---|---|
| 64400-CPT | Low | Njx Aa Strd Trigeminal Nrv, Injection S Anesthetic Agent S And Or Steroid Trigeminal Nerve Each Branch Ie Ophthalmic Maxillary Mandibular |
| 64405-CPT | Low | Njx Aa&/Strd Gr Ocpl Nrv, Injection Of Anesthetic Agent And/Or Steroid Into Greater Occipital Nerve Of Upper Neck And Back Of Head |
| 64408-CPT | Low | Inject Nerve For Pain Control, Injection Of Anesthetic Or Other Medicine Into A Nerve To Relieve Pain. |
| 64450-CPT | Low | Inject Anesthetic Agnt; Other Periphral Nrve Or Branch, Injection Anesthetic Agent; Other Peripheral Nerve Or Branch |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64400 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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