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See a sample rate comparisonCPT 64430 Fee Schedule
Last Verified: October 2026
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.
Njx Aa&/Strd Pudendal Nerve, Injection Of Anesthetic Agent And/Or Steroid Into Pudendal Nerve Of External Genitals And Area Around Anus
| 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 |
| Medicare Fee Schedule | View Medicare rates for 64430 |
| Medicaid Fee Schedule | View Medicaid rates for 64430 |
National average reimbursement for CPT 64430 by major payers:
$147.28
$159.53
$175.04
$117.97
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CPT 64430
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Port Charlotte Ltd
$4,215.00Published rateMetropolitan Medical Partners LLC, Surgery Center Of Chevy Chase
Metropolitan Medical Partners Ll
$953.00Published rateSouth Coast Surgery Center, LLC
South Coast Surgery Center LLC
$614.00Published rateCandescent Eye Surgicenter LLC
$384.00Published rateColumbia Eye Surgery Center Inc
$250.00Published rate
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See a sample payer proposalCPT 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 | N Block Inj Ilio-Ing/Hypogi, Injection Of Anesthetic Agent And/Or Steroid Into Ilioinguinal And Iliohypogastric Nerves Of Lower Abdomen And Groin |
| 64430-CPT | Low | Njx Aa&/Strd Pudendal Nerve, Injection Of Anesthetic Agent And/Or Steroid Into Pudendal Nerve Of External Genitals And Area Around Anus |
| 64435-CPT | Low | Inject Anesthetic Agnt; Paracervical (Uterine) Nrve, Injection Anesthetic Agent; Paracervical (Uterine) Nerve |
| 64445-CPT | Low | Injection Aa&/Strd Sciatic Nerve W/Img Gdn, Injection(S) Anesthetic Agent(S) And/Or Steroid; Sciatic Nerve Including Imaging Guidance When Performed |
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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