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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 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64420 |
| Medicaid Fee Schedule | View Medicaid rates for 64420 |
National average reimbursement for CPT 64420 by major payers:

$152.06

$163.14

$164.41

$116.96
Choose a payer to see a sample of rates for CPT 64420.
Cardiovascular Associates Surgery And Electrophysiology LLC
Filutowski Eye Institute, P.A.
Deaconess Hospital Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 64420 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64420 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 64420 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 Aa&/Strd Brachial Plexus W/Img Gdn, Injection(S) Anesthetic Agent(S) And/Or Steroid; Brachial Plexus Including Imaging Guidance When Performed |
| 64420-CPT | Low | Njx Aa&/Strd Ntrcost Nrv 1, Injection Of Anesthetic Agent And/Or Steroid Into Single Intercostal Nerve Of Rib |
| 64421-CPT | Low | Njx Aa Strd Ntrcost Nrv Ea, Injection S Anesthetic Agent S And Or Steroid Intercostal Nerve Each Additional Level List Separately In Addition To Code For Primary Procedure |
| 64447-CPT | Low | Anesthetic Infusion For Nerve, An Infusion Of Anesthetic Into A Nerve To Relieve Pain. An Infusion Delivers A Fluid Or Medication Over A Period Of Several Hours. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64420 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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