CPT 64486 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • 59 - Distinct Procedural Service • None • RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 64486 |
National average reimbursement for CPT 64486 by major payers:
$142.66
$161.25
$175.22
$195.73
| 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 64486 | ||||||
United | 64486 | $531.00 | 1124125604 - MURDOCK AMBULATORY SURGERY CENTER LLC | 201543128 - (FL) MURDOCK AMBULATORY SURGERY CENTE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $75.00 | 1073764106 - FLORIDA EYE CLINIC AMBULATORY SURGICAL CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $130.00 | 1740978386 - DUKE HEALTH INTEGRATED PRACTICE, INC, DUKE GI AT BRIER CREEK | 862109896 - DUKE HEALTH INTEGRATED PRACTICE INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $200.00 | 1811933179 - KALAMAZOO ENDO CENTER LLC | 201582174 - (MI) KALAMAZOO ENDO CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $534.00 | 1316462377 - UCSD SURGICAL CENTER OF SAN DIEGO, LLC | 822218664 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $1471.00 | 1487012480 - LAKE SPIVEY AMBULATORY SURGERY CARE, LLC, SPIVEY STATION SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $126.00 | 1740529064 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $150.00 | 1619291192 - DALLAS IVF SURGERY CENTER, LLC, DALLAS IVF SURGERY CENTER | 263473774 - (TX) DALLAS IVF SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $122.00 | 1609103399 - TOURNEY PLAZA SURGICAL CENTER | 262034187 - (CA) TOURNEY PLAZA SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $345.00 | 1962568543 - ENDOSCOPY CENTER OF OCEAN COUNTY, LLC | 223461117 - (NJ) ENDOSCOPY CENTER OF OCEAN COUNTY, PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $106.00 | 1205908456 - ENDOSCOPY CENTER -PINEVILLE LLC, CAROLINA ENDOSCOPY CENTER -PINEVILLE | 260317153 - (NC) ENDOSCOPY CENTER PINEVILLE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $4613.00 | 1306163431 - ROC SURGERY LLC, RILEY OUTPATIENT SURGERY CENTER | 271497960 - (IN) ROC SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $606.00 | 1346468253 - FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC | 208335586 - (MN) FAIRVIEW MAPLE GROVE SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $121.00 | 1528119252 - SAMSON PAIN CENTER | 43620515 - (GA) SAMSON PAIN CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $103.00 | 1083144653 - GREATER PITTSBURGH SURGERY LLC | 821512721 - (PA) GREATER PITTSBURGH SURGERY LLC | PA | 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 64486 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 64486 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 64486 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) |
| 64450-CPT | Low | Injection(S) Anesthetic Agent(S) And/Or Steroid; Other Peripheral Nerve Or Branch (Desc Rvsd 1/1/20) |
| 64486-CPT | Low | Transversus Abdominis Plane (Tap) Block (Abdominal Plane Block, Rectus Sheath Block) Unilateral; By Injection(S) (Includes Imaging Guidance, When Performed) |
| 64487-CPT | Moderate | Transversus Abdominis Plane (Tap) Block (Abdominal Plane Block, Rectus Sheath Block) Unilateral; By Continuous Infusion(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 64486. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 64486 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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