How does CPT 64479 compare to other Surgical Procedures on the Nervous System Codes?

The CPT 64479 code is part of the Surgery services for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter, unlike lower-level codes that require less time and simpler assessments. CPT 64479 typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements compared to codes like 64415 or 64480, but also differs from 64517.

What is a CPT code and why is it important for healthcare billing?

CPT (Current Procedural Terminology) codes are standardized five-digit codes developed by the American Medical Association (AMA) that describe medical, surgical, and diagnostic services. They are crucial for healthcare billing because they provide a uniform language for reporting medical services and procedures to health insurance companies, ensuring accurate processing of claims and reimbursement.

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

To get an accurate estimate for your specific situation, you should contact your healthcare provider's billing department and your insurance company. They can provide details based on your benefits, deductible, and out-of-pocket maximums. For general fee schedule information, including average prices for CPT codes in specific locations, you can utilize online tools like Payerprice, which helps you research potential costs.

What factors influence the price of a medical service?

Several factors influence the price of a medical service, including the type of facility (e.g., hospital vs. outpatient clinic), geographical location, the provider's experience and reputation, the complexity of the procedure, whether the provider is in-network or out-of-network with your insurance plan, and negotiated rates between providers and insurance companies.

Why do prices for the same medical service vary significantly between providers or locations?

Price variations for the same medical service are common due to differences in negotiated rates between healthcare providers and insurance companies, overhead costs of facilities (e.g., hospital systems versus independent practices), regional market competition, the level of technology and specialized staff employed, and whether the service is performed in an inpatient or outpatient setting.

What is price transparency in healthcare and how does it benefit consumers?

Healthcare price transparency refers to making the costs of medical services publicly available to consumers. This initiative aims to empower patients to make more informed decisions about their care by allowing them to compare prices for procedures and services from different providers. The benefit is to reduce unexpected medical bills, encourage competition among providers, and potentially lower overall healthcare costs.

CPT 64479 Fee Schedule

Q: What factors affect fee schedules?

Factors that affect 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: 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 Tfrm Epi C T 1, Injection S Anesthetic Agent S And Or Steroid Transforaminal Epidural With Imaging Guidance Fluoroscopy Or Ct Cervical Or Thoracic Single Level

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 LT - Left side of body RT - Right side of body
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 64479
Medicaid Fee Schedule	View Medicaid rates for 64479

National average reimbursement for CPT 64479 by major payers:

$331.96

$359.93

$379.32

$410.10

Compare published rates across providers.

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CPT 64479

5 of 25 sample ratesHigher to lower in this preview

Crozer-Chester Medical Center
PAAmbulatory Surgical Clinic/CenterNPI 1083776314Tax ID 81-1507712
$2,163.00Published rate
Physicians Surgery Center At Glendale Adventist, LLC
Physicians Surgery Center At Glendale Adventist LLC
CAAmbulatory Surgical Clinic/CenterNPI 1760807127Tax ID 46-4085815
$640.00Published rate
Johnna Wilson
Deaconess Hospital Inc
INPediatric Critical Care Medicine PhysicianNPI 1912369182Tax ID 35-0593390
$431.01Published rate
Coastal Medical Center LLC
FLAmbulatory Surgical Clinic/CenterNPI 1538231956Tax ID 65-0956639
$326.00Published rate
Lindsey Bowers
Deaconess Hospital Inc
INPhysician AssistantNPI 1770863342Tax ID 35-0593390
$198.02Published 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 64479 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 64479 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 64479 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 Aa&/Strd Brachial Plexus W/Img Gdn, Injection(S) Anesthetic Agent(S) And/Or Steroid; Brachial Plexus Including Imaging Guidance When Performed
64479-CPT	Moderate	Njx Aa Strd Tfrm Epi C T 1, Injection S Anesthetic Agent S And Or Steroid Transforaminal Epidural With Imaging Guidance Fluoroscopy Or Ct Cervical Or Thoracic Single Level
64480-CPT	Low	Njx Aa Strd Tfrm Epi C T Ea, Injection S Anesthetic Agent S And Or Steroid Transforaminal Epidural With Imaging Guidance Fluoroscopy Or Ct Cervical Or Thoracic Each Additional Level List Separately In Addition To Code For Primary Procedure
64517-CPT	Moderate	Injection, Anesthetic Agent; Superior Hypogastric Plexus

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64479. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 64479 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 64479 Fee Schedule

Crozer-Chester Medical Center

Physicians Surgery Center At Glendale Adventist, LLC

Johnna Wilson

Coastal Medical Center LLC

Lindsey Bowers