What factors affect CPT 64490 fee schedules?

Factors that affect fee schedules for CPT 64490 include government-set reimbursement amounts (Medicare & Medicaid Rates), negotiated rates between providers and insurance companies (Private Insurance Rates), Geographic Location (costs may be higher in urban areas), and Provider Type (hospital providers may have different rates than private practice).

How does CPT 64490 compare to other surgical codes?

The CPT 64490 code is part of Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter, involving more provider time and medical decision-making compared to lower-level codes, often including multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Where does PayerPrice get its CPT 64490 rate data?

PayerPrice displays raw data directly from insurers' files, providing the exact negotiated rates that insurers publish under federal price transparency rules for codes like CPT 64490.

How can I find the cost of a specific medical procedure before I get it done?

The cost of a medical procedure can vary significantly based on your location, the healthcare provider, your insurance plan, and other factors. For specific, localized fee schedule information based on CPT codes, you can use tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to get an estimate.

What is a CPT code and why is it important?

CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians and other healthcare providers to report medical, surgical, and diagnostic procedures and services to entities such as physicians, patients, and accreditation organizations. They are crucial for consistent and accurate billing and record-keeping in healthcare.

Where can I look up the fee schedule for a CPT code in my area?

To look up the fee schedule for a specific CPT code in your area, you should consider using a specialized lookup tool. Payerprice provides a fee schedule lookup tool where you can search by CPT code and specific location to find relevant pricing information.

Is the price of a medical procedure the same everywhere?

No, the price of a medical procedure is generally not the same everywhere. It can vary significantly based on factors such as the healthcare provider or facility, geographical location, your insurance coverage, and whether you are an in-network or out-of-network patient. Tools like Payerprice can help you understand these variations by providing localized fee schedule information.

CPT 64490 Fee Schedule

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.

Inj Paravert F Jnt C T 1 Lev, Injection S Diagnostic Or Therapeutic Agent Paravertebral Facet Zygapophyseal Joint Or Nerves Innervating That Joint With Image 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 RT - Right side of body LT - Left side of body
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 64490
Medicaid Fee Schedule	View Medicaid rates for 64490

National average reimbursement for CPT 64490 by major payers:

$237.63

$286.71

$281.35

$319.31

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 64490.

CPT 64490

5 of 25 sample ratesHigher to lower in this preview

Memorial Hermann Surgery Center Katy LLP
TXAmbulatory Surgical Clinic/CenterNPI 1760412803Tax ID 20-3360737
$2,666.00Published rate
Pacific Endoscopy Center LLC
Pacific Endoscopy Center, LLC
HIAmbulatory Surgical Clinic/CenterNPI 1104246446Tax ID 20-3905706
$967.00Published rate
Uropartners Surgery Center, LLC
Uropartners Surgery Center LLC
ILAmbulatory Surgical Clinic/CenterNPI 1437601200Tax ID 81-4131096
$570.00Published rate
National Surgical Centers Of America LLC, Nscoa
National Surgical Centers Of America LLC
FLAmbulatory Surgical Clinic/CenterNPI 1770724122Tax ID 26-4278807
$435.00Published rate
Carlisle Endoscopy Center, Ltd.
Carlisle Endoscopy Center Ltd
PAAmbulatory Surgical Clinic/CenterNPI 1033210760Tax ID 25-1871866
$200.00Published 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

This code appears in 1 published specialty market.

Explore state-level rates by specialty

CPT 64490 vs. Other Surgical Procedures on the Nervous System Codes

The CPT 64490 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 64490 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
64490-CPT	Moderate	Inj Paravert F Jnt C T 1 Lev, Injection S Diagnostic Or Therapeutic Agent Paravertebral Facet Zygapophyseal Joint Or Nerves Innervating That Joint With Image Guidance Fluoroscopy Or Ct Cervical Or Thoracic Single Level
64491-CPT	Low	Inj Paravert F Jnt C T 2 Lev, Injection S Diagnostic Or Therapeutic Agent Paravertebral Facet Zygapophyseal Joint Or Nerves Innervating That Joint With Image Guidance Fluoroscopy Or Ct Cervical Or Thoracic Second Level List Separately In Addition To Code For Primary Procedure
64492-CPT	Low	Inj Paravert F Jnt C T 3 Lev, Injection S Diagnostic Or Therapeutic Agent Paravertebral Facet Zygapophyseal Joint Or Nerves Innervating That Joint With Image Guidance Fluoroscopy Or Ct Cervical Or Thoracic Third And Any Additional Level S List Separately In Addition To Code For Primary Procedure
64493-CPT	Moderate	Inj Paravert F Jnt L S 1 Lev, Injection S Diagnostic Or Therapeutic Agent Paravertebral Facet Zygapophyseal Joint Or Nerves Innervating That Joint With Image Guidance Fluoroscopy Or Ct Lumbar Or Sacral Single Level

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 64490. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 64490 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 64490 Fee Schedule

Memorial Hermann Surgery Center Katy LLP

Pacific Endoscopy Center LLC

Uropartners Surgery Center, LLC

National Surgical Centers Of America LLC, Nscoa

Carlisle Endoscopy Center, Ltd.