CPT 64420 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 • 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 |
National average reimbursement for CPT 64420 by major payers:
$152.06
$163.14
$164.41
$188.28
| 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 64420 | ||||||
United | 64420 | $89.79 | 1225369440 - PHILLIP MARTIN | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 64420 | $433.00 | 1588323513 - RIVER POINT SURGERY CENTER, LLC | 863521069 - RIVER POINT SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $925.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $1158.00 | 1386657047 - THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CENTER, LLC | 20594510 - (TX) THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CTR, LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $897.00 | 1538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC | 205170962 - (CA) PHYSICIANS SURGERY CENTER OF | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $89.79 | 1447825377 - PAIGE RUDDICK | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 64420 | $89.79 | 1992203152 - CHRISTOPHER SANTOS | 350593390 - DEACONESS HOSPITAL INC | SC | Certified Registered Nurse Anesthetist (367500000X) |
United | 64420 | $166.00 | 1447442876 - MAPLE SPRINGS PODIATRIC SURGICAL CENTER, INC | 521883407 - (MD) MAPLE SPRINGS PODIATRIC SURGICAL CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $532.00 | 1255809620 - PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | 208397360 - (NE) PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $998.00 | 1245233220 - NORTHRIDGE SURGERY CENTER, LP, NORTHRIDGE SURGERY CENTER | 690003768 - (TN) NORTHRIDGE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $245.00 | 1740277821 - TRANSSOUTH HEALTH CARE PLLC, TRANSSOUTH HEALTH CARE PC | 621453805 - (TN) TRANSSOUTH HEALTH CARE, P.C. | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $689.00 | 1275256562 - CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY LLC, CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY | 920358251 - CARDIOVASCULAR ASSOCIATES SURGERY AND ELECTROPHYSIOLOGY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $184.00 | 1487779435 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER | 521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64420 | $195.41 | 1700855244 - THOMAS GREEN | 350593390 - DEACONESS HOSPITAL INC | NC | Internal Medicine Physician (207R00000X) |
United | 64420 | $1521.00 | 1154840064 - SOUTHHEALTH ASC, LLC, EDINA SPECIALTY SURGERY CENTER | 822364607 - (MN) SOUTHHEALTH ASC LLC | MN | 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 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(S) Anesthetic Agent(S) And/Or Steroid; Brachial Plexus Including Imaging Guidance When Performed (Desc Rvsd 1/1/23) |
| 64420-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Intercostal Nerve Single Level (Desc Rvsd 1/1/20) |
| 64421-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Intercostal Nerve Each Additional Level (List Separately In Addition To Code For Primary Procedure) (Desc Rvsd 1/1/20) |
| 64447-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Femoral Nerve Including Imaging Guidance When Performed (Desc Rvsd 1/1/23) |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 64420) and we'll show you how you compare in 15 minutes or less.