What is healthcare price transparency?

Healthcare price transparency refers to the ability for consumers to access clear and understandable information about the cost of healthcare services before receiving care. The goal is to empower patients to make informed decisions and compare prices among different providers and plans.

Why is it difficult to know healthcare costs upfront?

Healthcare costs are often complex and difficult to determine upfront due to several factors, including the negotiation of different rates between insurers and providers, the bundling of services, varying deductibles and co-pays, and a lack of standardized, easily accessible pricing information for specific procedures across all payers and locations.

How can I find out the cost of a specific medical procedure?

To find out the cost of a specific medical procedure, it's best to use tools designed for price lookup. For detailed, specific pricing based on CPT codes and your location, you can utilize Payerprice's fee schedule lookup tool. This tool allows you to search for negotiated rates, which can vary significantly depending on your specific situation.

What is a CPT code and why is it important for understanding medical costs?

CPT stands for Current Procedural Terminology. CPT codes are a standardized set of five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for understanding medical costs because they precisely identify the specific service or procedure performed, allowing for accurate billing and price lookups.

What is the difference between prices found on Payerprice and information from CMS regarding healthcare costs?

Payerprice provides a fee schedule lookup tool that allows users to search for specific negotiated rates using CPT codes and locations. These rates reflect commercial payer data, offering insights into actual prices charged to patients by various insurance companies. While CMS (Centers for Medicare & Medicaid Services) provides data related to Medicare and Medicaid reimbursement rates and some hospital price transparency files, Payerprice is specifically designed to give users access to commercial fee schedules and specific pricing based on their individual search criteria, making it more tailored for consumers looking for specific costs with their commercial insurance plans.

How do I use Payerprice's fee schedule lookup tool?

To use Payerprice's fee schedule lookup tool, you typically need to input the specific CPT code for the medical service or procedure you are interested in, along with your desired location. The tool will then provide you with relevant fee schedule information, helping you understand potential costs based on commercial payer data.

Is Payerprice's information applicable everywhere?

Payerprice's information is based on commercial fee schedules and is specific to the CPT codes and locations you search. While it provides valuable insights into negotiated rates, actual out-of-pocket costs can still vary based on your specific insurance plan (deductibles, co-pays, co-insurance), provider network status, and whether additional services are rendered. It's a powerful tool for estimating costs, but always confirm with your provider and insurer.

CPT 64454 Fee Schedule

Q: What factors affect fee schedules?

Factors affecting fee schedules include 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), and Provider Type (Hospital providers may have different rates than private practice).

Last Verified: September 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 Gnclr Nrv Brnch, Injection S Anesthetic Agent S And Or Steroid Genicular Nerve Branches Including Imaging Guidance When Performed

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Nervous System
Common Place of Service	24 - Ambulatory Surgical Center 11 - Office
Common Modifiers	None RT - Right side of body LT - Left side of body
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 64454
Medicaid Fee Schedule	View Medicaid rates for 64454

National average reimbursement for CPT 64454 by major payers:

$276.11

$292.87

$303.74

$350.30

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 64454.

CPT 64454

5 of 25 sample ratesHigher to lower in this preview

Physicians West Houston Surgical Center, LLC, Memorial Hermann Surgery Center Park Ten
TXAmbulatory Surgical Clinic/CenterNPI 1033586136Tax ID 37-1789833
$2,350.00Published rate
Ent Realty Corp, The Surgery Center
Ent Realty Corp
INAmbulatory Surgical Clinic/CenterNPI 1588640353Tax ID 35-1846420
$610.00Published rate
Gadsden Surgery Center Lp
ALAmbulatory Surgical Clinic/CenterNPI 1962467951Tax ID 62-1488653
$432.00Published rate
Plateau Surgery Center
TNAmbulatory Surgical Clinic/CenterNPI 1952535502Tax ID 26-4769256
$347.00Published rate
Oklahoma Lithotripter Associates, L.C., Oklahoma Kidney Stone Center
Oklahoma Lithotripter Associates, LLC
OKAmbulatory Surgical Clinic/CenterNPI 1750597449Tax ID 73-1415771
$262.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 64454 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 64454 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 64454 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
64400-CPT	Low	Njx Aa Strd Trigeminal Nrv, Injection S Anesthetic Agent S And Or Steroid Trigeminal Nerve Each Branch Ie Ophthalmic Maxillary Mandibular
64405-CPT	Low	Njx Aa&/Strd Gr Ocpl Nrv, Injection Of Anesthetic Agent And/Or Steroid Into Greater Occipital Nerve Of Upper Neck And Back Of Head
64454-CPT	Moderate	Njx Aa Strd Gnclr Nrv Brnch, Injection S Anesthetic Agent S And Or Steroid Genicular Nerve Branches Including Imaging Guidance When Performed
64455-CPT	Low	Injection Into A Foot Nerve, Injection Of A Steroid Or Numbing Agent Into The Main Nerve Running Across The Top Of The Foot To The Toes (Plantar Common Digital Nerve).

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64454. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 64454 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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CPT 64454 Fee Schedule

Physicians West Houston Surgical Center, LLC, Memorial Hermann Surgery Center Park Ten

Ent Realty Corp, The Surgery Center

Gadsden Surgery Center Lp

Plateau Surgery Center

Oklahoma Lithotripter Associates, L.C., Oklahoma Kidney Stone Center