CPT 64400 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 | • 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 |
National average reimbursement for CPT 64400 by major payers:
$144.24
$152.90
$172.39
$195.44
| 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 64400 | ||||||
United | 64400 | $300.00 | 1538386743 - HOWARD S BARNEBEY MD, SPECIALY EYECARE CENTRE | 911357221 - (WA) SPECIALTY EYE CARE CENTRE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $949.00 | 1578558763 - HUNT MEMORIAL HOSPITAL DISTRICT, HUNT REGIONAL HEALTHCARE | 751277293 - (TX) HUNT MEMORIAL HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $330.00 | 1821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $153.00 | 1710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK | 522239166 - (MD) ANDOCHICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $515.00 | 1760778765 - GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC, TOWN LAKE ENDOSCOPY CENTER | 274193796 - (GA) GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $51.00 | 1114951365 - DOCTORS SURGERY CENTER, PA | 710718664 - (AR) DOCTORS SURGERY CENTER PA | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $318.00 | 1326469172 - EHI SURGERY CENTER AUSTIN, LLC | 464266877 - (TX) EHI SURGERY CENTER AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $1004.44 | 1649748708 - ANKENY MEDICAL PARK SURGERY CENTER LC | 831281114 - (IA) ANKENY MEDICAL PARK SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $383.00 | 1134663677 - CASTLE HILLS SURGICARE, LLC | 813020487 - (TX) CASTLE HILLS SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $350.00 | 1962402503 - NORTH KITSAP AMBULATORY SURGERY CENTER, LLC, PACIFIC SURGERY CENTER | 911276412 - (WA) NORTH KITSAP AMBULATORY CENTER, INC. DBA PACIFIC SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $1071.00 | 1003138736 - NEWPORT SURGICAL PARTNERS LLC, NEWPORT PLAZA SURGICAL CENTER | 392060266 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $201.00 | 1750036174 - GLACIER SURGICAL INC. | 861271667 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $142.00 | 1174030878 - STUART SURGERY CENTER, LLC | 822542219 - (FL) STUART SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $250.00 | 1518955897 - BONITA COMMUNITY HEALTH CENTER INC, BONITA SPRINGS HEALTH CENTER | 593544102 - (FL) BONITA COMMUNITY HEALTH CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64400 | $688.00 | 1609274505 - BAY AREA SURGICAL SPECIALIST SERVICES, LLC | 471556346 - (CA) BAY AREA SURGICAL SPECIALIST SERVICES LLC | CA | 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 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 | Injection(S) Anesthetic Agent(S) And/Or Steroid; Trigeminal Nerve Each Branch (Ie Ophthalmic Maxillary Mandibular) (Desc Rvsd 1/1/20) |
| 64405-CPT | Low | Injection Of Anesthetic Agent And/Or Steroid Into Greater Occipital Nerve Of Upper Neck And Back Of |
| 64408-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Vagus Nerve (Desc Rvsd 1/1/20) |
| 64450-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Other Peripheral Nerve Or Branch (Desc Rvsd 1/1/20) |
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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