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 |
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 | $200.00 | 1821560434 - SUNSET PAIN SURGERY CENTER | 832872516 - (NV) SUNSET PAIN SURGERY CENTER | NV | 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 | $140.00 | 1689605826 - LAUREL SURGERY & ENDOSCOPY CENTER, LLC | 412044822 - (MS) LAUREL SURGERY AND ENDOSCOPY CENTER, LLC | MS | 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 | $91.00 | 1942272851 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - LIBERTY | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $89.33 | 1639331317 - OSAZE EDO-OHONBA | 350593390 - DEACONESS HOSPITAL INC | MO | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 64486 | $200.00 | 1780322750 - QUEENSRIDGE SURGERY CENTER | 862358950 - (NV) QUEENSRIDGE SURGERY CENTER | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $574.00 | 1134613979 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $174.00 | 1700842507 - ARCADIA OUTPATIENT SURGERY CENTER LP | 752285078 - (CA) ARCADIA OUTPATIENT SURGERY CENTER LP | CA | 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 | $300.00 | 1548837503 - HOUSTON IVF MANAGEMENT | 841602243 - (TX) HOUSTON IVF MANAGEMENT CO., LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $194.44 | 1568935344 - JAMES GILSTRAP | 350593390 - DEACONESS HOSPITAL INC | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 64486 | $79.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $64.00 | 1518579903 - AMIN SURGERY CENTER FOR WOMEN LLC | 843102358 - (GA) AMIN SURGERY CENTER FOR WOMEN LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 64486 | $62.00 | 1558328518 - BUTLER AMBULATORY SURGERY CENTER L L C | 61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, 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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