CPT 64455 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 64455 by major payers:
$69.31
$67.19
$69.12
$94.72
| 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 64455 | ||||||
United | 64455 | $574.00 | 1831420694 - TITUSVILLE CENTER FOR SURGICAL EXCELLENCE LLC | 263531997 - (FL) TITUSVILLE CENTER FOR SURGICAL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $839.00 | 1548791593 - BRIDGEWATER AMBULATORY SURGERY CENTER, LLC | 820860675 - (NJ) BRIDGEWATER AMBULATORY SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $240.00 | 1295918977 - WEST COAST CENTERS FOR SURGERIES LLC | 261572011 - (CA) WEST COAST CENTERS FOR SURGERIES LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $566.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $1108.00 | 1851367486 - GRHS, LLC, ROCHESTER AMBULATORY SURGERY CENTER | 453685937 - (NY) ROCHESTER AMBULATORY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $566.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $125.00 | 1346220183 - BLACK HILLS REGIONAL EYE SURGERY CENTER, LLC | 460462601 - (SD) BLACK HILLS REGIONAL EYE SURGERY CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $600.00 | 1689814998 - PUGET SOUND SURGICAL CLINIC INC | 911687859 - (WA) PUGET SOUND SURGICAL CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $555.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $628.00 | 1215939186 - ALL CITY FAMILY HEALTHCARE CENTER, INC. | 113423598 - (NY) ALL CITY FAMILY HEALTH CARE CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $325.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $78.00 | 1659363844 - LASER & SURGERY CENTER OF ACADIANA | 721288671 - (LA) LASER SURGERY CENTER OF ACADIANA | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $126.00 | 1144370784 - BELLINGHAM EAR NOSE THROAT AND FACIAL SURGERY INC, WHATCOM SURGERY CENTER | 911009308 - (WA) BELLINGHAM EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $108.00 | 1285944504 - NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK, LLC | 272840356 - (MD) NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64455 | $200.00 | 1316082365 - WEST WILSHIRE MEDICAL SURGICAL CENTER INC. | 954421811 - (CA) WEST WILSHIRE MEDICAL SURGICAL C | CA | 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 64455 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64455 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 64455 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 |
|---|---|---|
| 64451-CPT | Moderate | Injection(S) Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint With Image Guidance (Ie Fluoroscopy Or Computed Tomography) |
| 64454-CPT | Moderate | Injection, Anesthetic Agent &/Or Steroid; Genicular Nerve Branches, Including Imaging Guidance, When Performed - Deny Inv/N10=4/29/2023-5/3/2024 |
| 64455-CPT | Low | Injection(S), Anesthetic Agent(S) And/Or Steroid; Plantar Common Digital Nerve(S) (Eg, Morton's Neuroma) |
| 64486-CPT | Low | Transversus Abdominis Plane (Tap) Block (Abdominal Plane Block, Rectus Sheath Block) Unilateral; By Injection(S) (Includes 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 64455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64455 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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