CPT 64416 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • 59 - Distinct Procedural Service • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64416 |
National average reimbursement for CPT 64416 by major payers:
$133.54
$121.45
$149.37
$146.51
| 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 64416 | ||||||
United | 64416 | $344.00 | 1225517279 - ORLANDO OUTPATIENT SURGERY CENTER LLC | 821372628 - (FL) ORLANDO OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $390.00 | 1447385158 - HARBIN CLINIC, LLC, HARBIN GI | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $443.00 | 1174859516 - HERMITAGE TN ENDOSCOPY ASC, LLC, ASSOCIATED ENDOSCOPY | 270986942 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $1771.00 | 1699144915 - WEST ORANGE ASC LLC, GREGORI SURGERY CENTER | 474739080 - (NJ) WEST ORANGE ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $130.00 | 1386885556 - THE ASC AT WAUGH CHAPEL | 263869837 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $547.00 | 1114980166 - NEW PORT RICHEY SURGERY CENTER LTD | 592907068 - (FL) NEW PORT RICHEY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $400.00 | 1376616060 - NORTHSHORE SURGICAL CENTER, LLC | 202339324 - (LA) NORTHSHORE SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $552.00 | 1699054098 - SURGCENTER OF WESTERN MARYLAND, LLC | 272969860 - (MD) SURGCENTER OF WESTERN MARYLAND, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $330.00 | 1306956818 - WASHBURN SURGERY CENTER, LLC | 752748654 - (KS) WASHBURN SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $406.00 | 1235768490 - HENRY'S FORK SURGERY CENTER PLLC | 850508190 - (ID) HENRYS FORK SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $330.00 | 1992777643 - CAPE CORAL FT MYERS ENDOSCOPY ASC LLC, GULF COAST ENDOSCOPY CENTER SOUTH | 621767599 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $934.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $1955.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $637.00 | 1982873352 - BAHAMAS SURGERY CENTER LLC | 208025178 - (CA) BAHAMAS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64416 | $325.00 | 1487655627 - UNION PINES SURGERY CENTER,LLC | 731622427 - (OK) UNION PINES SURGERY CENTER, LLC | OK | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 64416 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64416 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 64416 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 |
|---|---|---|
| 64415-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Brachial Plexus Including Imaging Guidance When Performed (Desc Rvsd 1/1/23) |
| 64416-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Brachial Plexus Continuous Infusion By Catheter (Including Catheter Placement) Including Imaging Guidance When Performed (Desc Rvsd 1/1/23) |
| 64417-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Axillary Nerve Including Imaging Guidance When Performed (Desc Rvsd 1/1/23) |
| 64418-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Suprascapular Nerve (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 64416. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64416 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 64416) and we'll show you how you compare in 15 minutes or less.