CPT 64430 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 • 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 64430 by major payers:
$147.28
$159.53
$175.04
$191.41
| 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 64430 | ||||||
United | 64430 | $305.00 | 1144326307 - OLD MOULTRIE SURGICAL CENTER INC | 593572609 - (FL) OLD MOULTRIE SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $953.00 | 1871032680 - OLIVE AMBULATORY SURGERY CENTER, LLC, NORTH CAMPUS SURGERY CENTER | 203834012 - (MO) OLIVE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $250.00 | 1720175573 - COLUMBIA EYE SURGERY CENTER INC | 570879468 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $1625.00 | 1811973639 - SUMMIT ORTHOPEDICS LTD, DBA LANDMARK SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $487.00 | 1003205196 - PALM BEACH GARDENS REGIONAL SURGERY CENTER LLC | 874629018 - (FL) PALM BEACH REGIONAL OPCO LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $446.00 | 1497788277 - PACIFIC EYE SURGERY CENTER, PACIFIC SURGERY CENTER | 954200314 - (CA) PACIFIC EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $472.00 | 1801343496 - TRADITION SURGERY CENTER, LLC | 364837780 - (FL) TRADITION SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $934.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $953.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $514.00 | 1558327213 - SURGICARE OF JACKSON LTD | 752162993 - (MS) SURGICARE OF JACKSON LTD | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $589.00 | 1083796221 - SOUTHERN INDIANA SURGERY CENTER, LLC, SOUTHERN INDIANA SURGERY CENTER | 351829838 - (IN) SOUTHERN INDIANA SURGERY CENTER | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $637.00 | 1699780247 - CENTER FOR ORTHOPEDIC SURGERY, LLC | 203140907 - (CA) CENTER FOR ORTHOPEDIC SURGERY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $324.00 | 1649219536 - USC, LLC, UNASOURCE SURGERY CENTER | 352175811 - (MI) USC, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $419.00 | 1013298926 - MATTHEWS SURGERY CENTER, LLC | 273634811 - (NC) MATTHEWS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64430 | $1553.00 | 1902204654 - DENVER SURGICENTER, LLC | 472340660 | CO | 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 64430 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64430 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 64430 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 |
|---|---|---|
| 64425-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Ilioinguinal Iliohypogastric Nerves (Desc Rvsd 1/1/20) |
| 64430-CPT | Low | Injection Of Anesthetic Agent And/Or Steroid Into Pudendal Nerve Of External Genitals And Area Aroun |
| 64435-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Paracervical (Uterine) Nerve (Desc Rvsd 1/1/20) |
| 64445-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Sciatic 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 64430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64430 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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